The Province has taken a significant step forward in honouring its commitment to establishing an Organized Stroke Care model in Prince Edward Island announced Premier Robert Ghiz and Health and Wellness Minister Carolyn Bertram during an event at Queen Elizabeth Hospital (QEH) celebrating the implementation of the first phase of the three-phased model.
“Government’s number one priority is the provision of quality health care services and programs for Islanders,” said Premier Ghiz. “We made a commitment one year ago to implement a provincial Organized Stroke Care program when the need was identified. We are pleased to be able to honour this commitment and help improve the lives of Islanders who suffer a stroke by providing timely access to coordinated, quality stroke care resources and services.”
Organized Stroke Care will improve patient outcomes after a stroke. It promotes a coordinated approach with early assessment, mobilization and rehabilitation for every patient who can benefit. The model will be implemented in three phases over a four-year period. The first phase of the Organized Stroke Care model outlines the establishment of provincial level services over two years (2009 - 2011) and includes: creating and filling a Provincial Stroke Care Coordinator position; instituting an acute in-patient stroke unit and stroke rehabilitation unit at the QEH; and creating provincial secondary prevention services at Prince County Hospital (PCH).
Provincial coordination and collaboration are crucial to the successful implementation of organized stroke care in PEI. Earlier this year, Carolyn MacPhail was hired to fill the role of Provincial Stroke Care Coordinator and a Provincial Stroke Steering Committee, chaired by Dr. Reg Hutchings, neurologist at the QEH, was created to guide and coordinate the effective implementation and integration of the Organized Stroke Care model. The Provincial Stroke Care Coordinator will ensure that work is carried out in a coordinated, timely and effective manner.
A foundational element of the Organized Stroke Care model is in-patient care, which includes management on an Acute Stroke Unit followed by intensive rehabilitation on a Stroke Rehabilitation Unit. Both of these units have been designated at the QEH as it is the provincial referral hospital and there is more timely access to specialized health care staff such as neurologists and physiatrists as well as to the Provincial Rehabilitation Unit, which is already located at the QEH.
“Working as an integrated health care system, we will ensure that stroke care is provided in a manner that is patient-oriented across a continuum of care to meet their specific needs. Government’s $3 million investment in and implementation of a stroke care model continues to demonstrate our commitment to our One Island Community and One Health System,” said Minister Bertram. “I want to thank the Heart and Stroke Foundation and Island EMS for their dedication to improving stroke care for Islanders and their families. I would also like to recognize the Queen Elizabeth and Prince County Hospital Foundations for their fundraising and contribution toward the purchase of much-needed specialized equipment. It is because of their collective efforts that we have been able to further advance stroke care on PEI and have a positive impact on the quality of life not only for the stroke survivor, but for their families and caregivers.”
Stroke care will be provided through collaborative care between health professionals with special interests and expertise in stroke care. Core team members will include primary care physicians, specialist physicians such as neurologists and physiatrists, nurses, speech language pathologists, occupational therapists, physiotherapists and social workers. Other disciplines such as dietetics, psychology and spiritual care will complement the team on an as-needed basis.
The 10-bed Acute Stroke Unit at the QEH will be under the medical direction of Dr. Reg Hutchings, and is located within Unit 8 at the hospital. The 10-bed Stroke Rehabilitation Unit will be under the direction of Dr. Ed Harrison, physiatrist and Director of Physical Medicine and Rehabilitation at the QEH, and is located adjacent to Unit 7 (Provincial Rehabilitation Unit) at the QEH.
“There are many benefits associated with organized stroke unit care,” said Dr. Hutchings. “It has been demonstrated to significantly improve survival and reduce complications, improve functional outcomes with particular reduction in disability, reduce length of stay in hospital, increase the number of patients discharged to home or community settings rather than institutional care, and improve quality of life for the patient.”
Under the Organized Stroke Care model, patients on the Acute Stroke Unit and Stroke Rehabilitation Unit will be receiving the breadth and intensity of specialized health care based on Canadian Stroke Strategy best practices. Planning is also well underway for the third element of this first phase of the Organized Stroke Care model – creating provincial secondary stroke prevention services at PCH. Secondary stroke prevention is focused on patients who have had a stroke or a transient ischemic attack (TIA or stroke not yet completed). The secondary prevention clinic is expected to be up and running by the fall of 2010.
Phase two, establishment of ambulatory stroke services, and phase three, establishment of community re-integration services, will be implemented over the next two years.
Stroke is the third leading cause of death and the leading cause of disability. In PEI, there are approximately 350 strokes annually – this equals about one stroke every day.