Background

Evidence supporting the efficacy of stroke unit care for persons post-stroke was solidified with the release of the Stroke Unit Trialists Collaboration in 2007. Although planning, development and implementation of stroke units within designated stroke centres was becoming more common at the time, access to stroke unit care in non-designated and community hospitals remained limited. Since 2009, in Central South Ontario, Canada stroke unit development has been prioritized as a key strategic goal to optimize access to best practice stroke care for all.

Objective

To demonstrate integration strategies that resulted in fulsome stroke unit access for 2.2 million people across approximately 11,945 square kilometers in the Central South Region. 

Methods

Facilitated by the Central South Regional Stroke Network, senior leaders for hospitals in the region endorsed the ideal of stroke unit care for all persons with stroke. Through geographically unique collaborations, stroke flow algorithms and expanded capacity, efforts were made to achieve this goal.

Results

As a result, currently 20 of 22 (91%) individual hospitals have agreements to either transfer out or accept patients to a dedicated acute stroke unit. 

Conclusion

By fall of 2018, with the addition of a stroke unit within one local hospital, as well as a regional re-routing agreement for stroke patient transfer within another local community hospital, this strategic goal will be achieved. Through the removal of organizational and geographic barriers, all persons with stroke within the Central South Region will have access to best practice stroke unit care.

Realizing Stroke Unit Access for Everyone: Access to Acute Stroke Units across a Large and Populous Geographic Region