Authors' objectives:

Stroke is the fourth leading cause of death and a leading cause of adult disability in Canada. In Ontario, previous studies have shown wide variations in the availability of stroke care resources in acute care institutions across the province, as well as variations in the treatment of stroke patients in organizations with similar resources. In 2000, Ontario developed a
“coordinated stroke strategy” order to address these inconsistencies, and to ensure that Ontarians have equal access to high-quality stroke care. The goal of the stroke strategy was to improve both access to and quality of services across the continuum of stroke care—from primary prevention to pre-hospital/emergency care, hospital-based acute care,
rehabilitation, secondary prevention and community re-engagement. The strategy, which was fully implemented by 2005, is now known as the Ontario Stroke System (OSS). The OSS includes a number of regional stroke centres and other institutions which provide specifi c stroke care resources throughout the province.
Within the Ontario Stroke Strategy, ongoing monitoring and evaluation are considered essential to ensure implementation of best practices and evidence-based stroke care. The Registry of the Canadian Stroke Network (RCSN) was established in 2001. Its mandate includes ongoing measurement and monitoring of the quality of stroke care delivery in Ontario. One component of the RCSN is a province-wide audit of stroke care in Ontario, which is performed every two years. This report presents data obtained from the RCSN Ontario Stroke Audit for fi scal year 2004/05, with comparisons to the previous audit performed for fi scal year 2002/03.

Authors' recommendations: In summary, compared to a similar audit done in 2002/03, the RCSN 2004/05 Ontario Stroke Audit revealed significant improvements in the use of evidence-based practices and interventions such as referral to stroke units, thrombolysis, neuroimaging, swallowing assessments, secondary prevention drug therapy and referrals to secondary prevention clinics. Although our analysis does not allow us to evaluate the reasons for the observed improvements in care, there is a temporal association between the implementation of the Ontario Stroke System and improved stroke care delivery. However, variations in care delivery among hospital types continue to exist, with lower rates of many stroke care interventions at small community hospitals compared with other hospital types.

Project Status: Completed

URL for project: http://www.ices.on.ca/file/RCSN_2004-05%20Ontario%20Stroke%20Audit%20Report_Final_April%2006.pdf

Year Published: 2009

URL for published report: Errata: http://www.ices.on.ca/file/Errata_Apr8-09.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute for Clinical Evaluative Sciences

Contact Address: Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, G-Wing, Toronto ON, Canada, M5N 3M5. Tel: 416-480-4055; Fax: 416-480-6048

Contact Name: info@ices.on.ca

Contact Email: info@ices.on.ca

Copyright: Institute for Clinical Evaluative Sciences (ICES)