As Stroke Month comes to a close, evaluations show that stroke care in Prince Edward Island is improving, says Dr. Ed Harrison, medical director of the Physical Medicine and Provincial Rehabilitation unit at the Queen Elizabeth Hospital.
“Over the past several years, we have been able to implement many components of the provincial organized stroke care program,” says Dr. Harrison, who is also chair of the Provincial Organized Stroke Care Evaluation and Monitoring subcommittee. “It is important that we monitor and evaluate the quality of the various specialized care services to ensure that the stroke care we are providing is improving along with the outcomes of our stroke patients.”
Since the first phase of the Organized Stroke Care program was implemented in 2010, Health PEI has made great strides in improving timely access to dedicated and organized stroke care in Prince Edward Island – both acute stroke and stroke rehabilitation.
• 54 percent of stroke patients spent time in the acute stroke unit at the QEH in 2010. In 2012, preliminary data indicates 72 percent of stroke patients spent time in the acute stroke unit.
• In 2010, 36 percent of stroke patients received a rehabilitation assessment within the suggested 48-hour time period following admission to hospital. In 2012, preliminary data indicates 81 percent of patients received a rehabilitation assessment within 48 hours.
Improved access has meant that patients are generally spending fewer days in hospital due to more focused care.
• Ischemic stroke (stroke due to a blockage in an artery to the brain) patients spent an average of 27.4 days in hospital in 2009 compared to 21.8 days in 2011.
• Hemorrhagic stroke (stroke due to a rupture in an artery to the brain) patients spent an average of 45.1 days in hospital in 2009 compared to an average of 37.3 days in 2011.
• The percentage of stroke patients able to return home following rehabilitative hospital care has increased from 63 percent in 2008 to 82 percent in 2011.
“Although stroke can occur at any age, we know the risk of having a stroke increases with age,” said Deborah Bradley, Health PEI executive director of Community Hospitals and Primary Care and acting chair of the Provincial Organized Stroke Care steering committee. “It’s important that Islanders do what they can to manage other risk factors that they can control to help reduce their risk of having a stroke. We are certainly working together as a health care system to ensure that we are providing the best and most timely access to stroke care for Islanders. While we have made great strides over the past few years, we have more to make.”
With the first two phases of the provincial organized stroke care program underway, staff and stakeholders are now focused on Phase III planning in the area of community re-integration.
For more information on Prince Edward Island’s organized stroke care program, visit www.healthpei.ca/stroke.
Background:
With the support of an epidemiologist from the Department of Health and Wellness, Health PEI evaluated several core stroke performance indicators included in the Accreditation Canada Stroke Distinction Program, as well as other demographic data trends such as age and risk factors. Those results indicated:
• Highest proportion of stroke patients occurred in the age group 80 to 89; however, there is a trend of stroke occurring in men at a younger age (average age is 72) compared to women (average age is 77).
• Most prevalent risk factor among stroke patients in Prince Edward Island is high blood pressure (or hypertension) with a range of 77 to 83 percent prevalence. Other risk factors identified include: previous stroke or TIA (39 to 42 percent), current and/or former smoker (37 to 41 percent), history of diabetes (30 to 35 percent). Generally speaking, Prince Edward Island has higher rates for risk factors when compared to the national averages which are due, in large part, to the stroke population being older as well as higher rates of smoking, diabetes, etc. among the general population in Prince Edward Island.
Organized Stroke Care promotes a coordinated approach to early detection and assessment of warning signs of stroke, and timely access to appropriate treatments and specialized health care providers.
Goals of the Organized Stroke Care program:
• Reduce the incidence of stroke in PEI
• Reduce deaths and disabilities due to stroke
• Reduce the financial burden of stroke
• Improve recovery from stroke
• Improve the quality of life for stroke survivors
Organized Stroke Care Implementation Timeline:
Phase I: Provincial-level Services (complete)
• Provincial Stroke Care Coordinator position
• Provincial Acute Stroke and Stroke Rehabilitations Units at QEH
• Secondary Stroke Prevention Clinic at PCH (pilot program)
Phase II: Ambulatory Stroke Services (implementation nearly complete)
• Ambulatory (outpatient) stroke rehab services QEH and PCH
• Provincial stroke rehabilitation assessment clinic
• Provincial Stroke Prevention Services
Phase III: Community Re-integration Services (in planning process)
• Access to therapy (out-patient or in-home)
• Community support services