The 2010 Best Practice Recommendations for Stroke Care, Section 5.1, Rehabilitation - Assessment Recommendation, states that “Clinicians should use standardized, valid assessment tools to evaluate the patient’s stroke related impairments and functional status.”  The Southeast Region Stroke Network is involved in ongoing reflection and action planning towards implementation of stroke best practice in outcome measures use.   Outcome Measures Workshops have been held both Belleville and Kingston areas, with similar Workshops being planned for the Perth, Smiths Falls and Brockville areas. 

To view the Hastings, Prince Edward (Belleville area) Final Report
 click here

To view the Kingston, Frontenac, Lennox & Addington Final Report
 click here

To view an introductory powerpoint on the use of outcome measures
 click here

Primary Care Stroke Algorithm Tool
December 1, 2008 - March 31, 2010

For further information on this project, please contact Principal Investigator, Dr. Kathryn Lockington, Family Physician, Maple Key Clinic, Maple Family Health Team at 613-546-9721.

This project has been funded by the Ontario Stroke System Research Fund, Ministry of Health and Long Term Care.

This project involves researching and developing Primary Care stroke tools in the areas of: High Risk Stroke Population Identification and Management; Post-Stroke Management, Recovery and Community Re-integration.
These tools would be in the form of care pathways/algorithms developed in conjunction with available research and best practice guidelines. An education program would accompany the development of these tools. These algorithms would be converted into Electronic Health Record forms and be implemented as part of daily practice within the Maple Family Health Team, and evaluated.
By implementing such a tool, consistent, efficient, and quality evidence-based practice will be enabled, with desired outcomes of minimizing the incidence of strokes and assisting patients with secondary prevention, recovery and community re-integration.

Enhancing Community-Based Stroke Rehabilitation in Southeastern Ontario: Improving the System of Stroke Care

Timely, enhanced community and LTC rehabilitation services have been provided to stroke survivors in Southeastern Ontario since February 2009 with the launch of an innovative LHIN-funded project.  In April 2011, recognizing the critical role this enhanced service plays in both improving stroke survivors' functional outcomes and health system utilization as evidenced by reduced lenths of stay, the LHIN committed to supporting the service as a regional standard of service in support of best practice in stroke care.

Eligible stroke survivors have and will continue to be considered for enhanced Physiotherapy, Occupational Therapy, Social Work and Speech Language Pathology services for two months following discharge home or to Long Term Care.  Objectives of the enhanced rehabilitation services in the community and long term care include:
 

• For Stroke Survivors:  to improve access to timely enhanced community and LTC rehab services for improved function, emotional support and satisfaction with transition to home. 
   
• For Health Care Providers:  to improve information flow and stroke care expertise.
   
• For the Health Care System:  to decrease length of stay, Emergency Room visits and hospital readmissions by supporting transition to home for those with new stroke, providing timely enhanced community and LTC rehabilitation support.
   

 Enhancing Community-based Stroke Rehabilitation in Southeastern Ontario: Improving the System of Stroke Care

 Enhanced Rehab Therapy for Stroke Communique Update November 2011

Evaluation of the Implementation of the Revised Paramedic Prompt Card for Acute Stroke Protocol in Eastern Ontario 

Paramedics in Ontario play an integral role in identifying patients that may be having an acute stroke and transporting directly to a Designated Stroke Centre.   By doing so they ensure patients have timely access to hospitals where definitive hyperacute stroke treatment can be administered.   A regional acute stroke protocol was first implemented in 1999 in Southeastern Ontario and in 2004,  a provinical Paramedic Prompt Card for Acute Stroke Protocol was implemented across Ontario.  This tool authorized paramedics to bypass local hospitals and transport patients directly to Designated Stroke Centers for patients who meet the criteria outlined on the Paramedic Prompt Card.  In 2011, the screening tool was revised based on the Canadian Best Practice Recommendations for Stroke Care.

 

The Southeastern and Champlain Regional Stroke Networks, nine Eastern Ontario EMS/paramedic services, Emergency Departments in Kingston and Ottawa, Belleville, Pembroke, Cornwall, and Hawkesbury and the Regional Paramedic Program for Eastern Ontario, are collaborating with Dr. Ian Stiell, the principal investigator,  Senior Scientist, Ottawa Hospital Research Institute to evaluate the revised Paramedic Prompt Card. The overall goal is to evaluate the impact and effectiveness of implementing the revised screening tool.  Specific objectives include determining the predictability of the Paramedic Prompt Card for screening patients for an acute stroke; Frequency and severity of adverse patient outcomes during transport, particularly for longer transport times; Interrrater reliability of paramedic interpretation of the Paramedic Prompt Card criteria; Patient impact including number of patients who receive thrombolysis and their outcomes; System impacts including operational efficiencies both with Paramedic services as well as emergency departments. This prospective cohort study is primarily funded by the Ontario Stroke Network with the Ontario Paramedic Research Consortium as a second funding agent.

 

For more information please contact the Study Coordinator: Kristy Smaggus, Regional Paramedic Program of Eastern Ontario (RPPEO), Tel: (613)737-7593; email: ksmaggus@rppeo.ca

To view the MoH Training Bulletin, click below: 

 MoH Training Bulletin