Access to specialist hospital services is crucial for stroke patients, write Professor Bernard Yan and Kelvin Hill.
Access to a dedicated hospital stroke unit makes the biggest difference to outcomes in patients who present with stroke. However, currently, not all Australians have such access.
If we want to improve the way people receive the best treatment for stroke, this needs to change.
The Australian Stroke Coalition (co-founded by Stroke Society of Australasia and Stroke Foundation) characterise a stroke unit as a facility in which medical, nursing and allied health professionals with expertise in stroke provide coordinated care in a geographically co-located environment.
Provision of these services differ from state to state and depend on the budget priorities of each hospital and state government.
Having a robust way of recognising which hospitals have the essential elements of stroke unit care is an important first step to ensure the quality of care and patient outcomes, but the information can also be used to positively influence the whole system.
Results from the Stroke Foundation’s 2021 national acute services audit show that not all Australian hospitals are meeting the requirements outlined in the Australian Stroke Services Framework and Acute Stroke Care standards.
While more than 80% of patients who had been in dedicated stroke units left hospital with a comprehensive discharge plan, of those who did not receive their care in a specialised unit only 62% were discharged with bespoke recovery advice.
We believe that meeting agreed national standards is an important step in ensuring all Australians receive the same level of care, regardless of where they live.
That is why the Australian Stroke Coalition, which is co-chaired by Stroke Foundation and the Stroke Society of Australasia and includes representatives of those working in the field, is launching a pilot project to implement a certification scheme for stroke units.
Participation will be voluntary. Our aim is to develop a certification scheme which hospitals with stroke units can agree to participate. The spirit of the scheme arises from the collective will to lift our game. We want to emphasise that this is never about penalising the services which currently fall short.
We are recruiting a part-time senior project officer who will coordinate the project over the next 12 months. When we roll it out to stroke units, there will be clear guidance on participation and the expected impacts and outcomes.
In the past 25 years the way stroke is treated has evolved substantially, but we can always do better. We can save more lives, and we can ensure survivors of stroke have even better outcomes.
Almost 30,000 people experience stroke each year. We want to work with Australian stroke units to ensure they have the processes in place and the appropriate resourcing to deliver the optimal level of care to patients.
ED: Professor Bernard Yan is president of the Stroke Society of Australasia and Kelvin Hill is national manager of clinical services with the Stroke Foundation.