Effectiveness of efficient stroke networks
"High-quality care and services for people with stroke or at risk of stroke need to be delivered by staff with stroke specialist knowledge. The challenge is to ensure capability, capacity, and collaborative working both within stroke teams and across providers and commissioners so that there is an overall focus on delivery of high-quality stroke care and services."1
"Networks for stroke have real potential to improve the way that services are planned and delivered for both individuals with stroke and staff... Organisations join networks because they can do what they need to do more effectively together than if they operate alone."1
Stroke networks (figure 1) and protocols are crucial for the optimisation of patient management to ensure as many patients as possible are treated as quickly as possible.
Figure 1: The components of a stroke network
(Source: Hacke. Personal communication 2011, unpublished.)
Centralised emergency number ensures one stop access to stroke care Call centre triages patients prior to dispatch of emergency team Transport patient to a stroke centre as quickly as possible after symptom onset
- Direct transport to stroke centre
- Rapid transfer from non-stroke centre
24/7 acute specialty cover within a region Ensure the right care for the right patient at the right time Ongoing coordination of multiple clinical services throughout stroke care
Figure 2: Advantages of integrated stroke networks
Carr et al. Acad Emerg Med 2010;17:1354-1358. Rymer. OMAG Mar-Apr 2010, available online.
- A case-cohort study of data from the Registry of the Canadian Stroke Network (RCSN) showed a graded survival improvement with higher levels of access to care for all age groups.4
- The data provide real-world evidence of the effectiveness of collaborative, high-quality, standardised, and effective care in reducing poor outcomes for stroke victims regardless of age.
- National Stroke Strategy 2007, available online. www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_081059.pdf
- Carr BG, Matthew Edwards J, Martinez R. Regionalized care for time-critical conditions: lessons learned from existing networks. Acad Emerg Med 2010;17:1354-1358.
- Rymer MM. Stroke centers and regional networks: A blueprint for improving outcomes. Mo Med 2010;107(2):131-3,134.
- Saposnik G, Kapral MK, Coutts SB et al. Do all age groups benefit form organized inpatient stroke care? Stroke 2009;40:3321-3327.