Prevention & Vascular Health

General

Stroke Prevention Resources 

The following resources were developed to further operationalize core elements of Ontario’s Stroke Prevention Clinics and to enhance and support system-wide performance and outcomes for persons with transient ischemic attack (TIA) or minor non-disabling stroke.  Elements of the documents are modifiable to reflect available resources in local settings. Click here for more info & see below descriptions about the resources.

1) Stroke Prevention Infographic for Primary Care Providers

Provides general information about the role of the Stroke Prevention Clinic, how to refer to the Clinic, and what treatment providers could initiate after imaging has been completed and reviewed. Click here to view and/or print the South East Infographic. 

2) Standardized Secondary Stroke Prevention Clinic Referral Criteria

Helps improve access and establishment of referrals to Stroke Prevention Clinics/services. The referral form template includes a triage algorithm based on Canadian Stroke Best Practice Recommendations and Carotid Stenosis consultation recommendations. Click here to view and/or print the referral template and click here for the fillable version.

3) Stroke Prevention Clinic Patient Summary

Serves as a communication tool to support education and discharge information for patients & families/caregivers and can be used for ongoing communication beyond the Stroke Prevention Clinic. Click here to view and/or print the Stroke Prevention Clinic summary and click here for the fillable version.

4) Stroke Prevention Clinic Triage Algorithm

The “Ontario Triage Algorithm for Stroke Prevention Clinic (SPC) Referrals” is intended to help guide “how” SPCs can triage referrals based on the clinical information received. The provincial SPC Triage algorithm serves as a guide only for SPC use for their own internal triage purposes. The algorithm can be modified to suit local SPC needs: 

5) Virtual Care Stroke Prevention Clinic Resources

Virtual care resources have been developed to support Stroke Prevention Clinic service delivery models and ensure best practice and timely access to care.

Virtual Care Resources for Stroke Prevention Clinics:

Click here to view a webinar about the Stroke Prevention Clinic Triage Algorithm and Virtual Care Stroke Prevention Clinic Resources.

6) Patient and Family Education

The Provincial Stroke Prevention Task Group developed a new resource guide, Secondary Prevention Education Resources for Patient, Family and Caregivers after a Stroke/TIA. It is a repository of suggested resources that can be given to patients, family members, and caregivers to support secondary prevention education. The document is separated into general topics as outlined in the Table of Contents. The guide itself is NOT intended to be used as a handout, but rather to support healthcare providers in identifying available resources and in differing formats.

Primary Care/Stroke Prevention Clinic CMEs

Primary Care and Stroke Prevention Clinic Updates were held March 2018, February 2020 & February 2022.  The Updates provided an opportunity to learn about new stroke best practices, as well as identify common challenges and opportunities to enhance care.

Click here for a summary of the 2018 & 2020 discussions at the Events as well as links to key resources.

Click here for a summary of the 2022 discussions at the Event as well as links to key resources. 

Heart and Stroke Foundation Prof Ed Stroke Prevention Resources

Ontario Stroke Prevention Clinic Resources

The goal of outpatient management of TIA and non-disabling stroke is rapid assessment and management to reduce the risk of recurrent event or stroke. In Ontario, this is facilitated by Stroke Prevention Clinics or the equivalent. A provincial working group was tasked with updating the provincial Stroke Prevention Clinic model of care. 
The workgroup identified resources including strategies to operationalize best practice core elements in Secondary Stroke Prevention Clinics. The resources include:

  • Stroke Prevention Clinic Core Elements and Self-Assessment Tool. The core elements reflect provincial standards of care originally put forth in 2001 and are based on the updated Canadian Stroke Best Practice Recommendations
  • Implementation Toolkit of practical resources and strategies. The toolkit was informed by self-assessment results from Stroke Prevention Clinics across Ontario
  • Quality Indicators providing a common reference guide for evaluation and measurement of secondary stroke prevention care.

The secondary stroke prevention resources can be accessed here.

Atrial Fibrillation

Canadian Cardiovascular Society has guideline knowledge translation tools including quick reference pocket guides for atrial fibrillation.

Anticoagulation guidelines for people with stroke and atrial fibrillation

Anticoagulation Adherence

  • Discussions took place at the Southeastern Ontario Primary Care/Stroke Prevention Clinic CME events in March 2018 & February 2020, Regional Stroke Symposium in 2019, and during the annual regional Stroke Prevention Clinic meetings about possible local barriers and opportunities to improve anticoagulation adherence. 

  • Click here for a summary of these discussions, key resources, and a more detailed summary of the 2020 event's session.

Blood Pressure

The Hypertension Management Program for Primary Care

The Hypertension Management Program Toolkit (Toolkit) helps primary care organizations assess where they are with respect to hypertension management, and provides practical resources for implementing real change to meet chronic disease prevention and management approaches to support their patients. Built on the knowledge of the Hypertension Management Initiative study and years of the Hypertension Management Program (HMP) running as a Ministry of Health and Long Term Care funded program, this toolkit enables broader audiences to advance their approach to hypertension management.

Hypertension Canada

Hypertension Canada is the only national non-profit organization dedicated solely to the prevention and control of hypertension and its complications. On their website you will find reosurces for professionals as well as for patients. Click below to directly access specific resources:

Hypertension Guidelines Full document (for providers)

Hypertension Primary Care Guidelines 

Highlights (for providers)

BP Action Plan (for patients)

BP Measurement Postcard (for patients)

Hypertesion Medical Directives

Medical directives have been developed following the recommended Federation of Health Regulatory Colleges of Ontario medical directives template and are based on best practice guidelines and clinical expertise. A fillable medical directive has been created related to Hypertenion- click here to access it.

Sodium Resources:

Reducing the amount of sodium taken each day lowers your blood pressure.

Depression

A Post-Stroke Depression Session was held during the 2020 Primary Care/Stroke Prevention Clinic Event. Health care professionals surveyed during the preparation for this event, as well as from a previous similar event and discussion with Stroke Prevention Clinics (SPC) and the Vascular Protection Clinic (VPC), indicated a need to learn more about screening and management for post stroke depression.

Click Here for a brief summary of the discussion and recommendations from the Event, as well as key resources and a more detailed summary.

Healthy Living

Ottawa Model for Smoking Cessation

 Smoking Cessation Maps

Navigation maps for smoking cessation resources have been created by the Tobacco Control Area Network of the three Public Heath Units. All three smoking cessation maps can be found in the SouthEastHealthline.ca Vascular Health Resources directory under the Vascular Health Promotion Smoking Cessation section. View maps under "downloads" via links below: 

Smoking Cessation Medical Directives

Medical directives have been developed following the recommended Federation of Health Regulatory Colleges of Ontario medical directives template and are based on best practice guidelines and clinical expertise. Three fillable medical directives have been created related to smoking cessation:  Nicotine Replacement Therapy (NRT), Bupropion, and Varenicline. These and other vacular resources can be found on the CorHealth website by clicking here.

Recreational Substance Use

The Centre for Addiction and Mental Health (CAMH) has produced several guidelines and resources including Canada's Lower Risk Cannabis Use Guidlines, as well as an info sheet outlining 10 ways to reduce risk when using Cannabis.

 Physical Activity Maps

Navigation maps of physical activity programs and common resources have been created by the Southeastern Ontario Health Collaborative for each of the three public health geographic areas in our region. The intent of the maps is to support primary and community care providers in more easily determining which types of physical activity services to recommend with their patients for primary and secondary prevention. The maps include programs which are low cost or no cost and offer physical activity on site. For specific information about the programs included on the maps, please contact the associated service provider. Feedback on these maps is welcomed via PAmapfeedback@kflaph.ca View maps via links below: 

Exercise is Medicine®

The vision of Exercise is Medicine® (EIM), a global health initiative managed by the American College of Sports Medicine (ACSM), is to make physical activity assessment and promotion a standard in clinical care, connecting health care with evidence-based physical activity resources for people everywhere and of all abilities. Their website has several resources and tools, including the Physical Activity is Medicine Rx Sheet.

Obesity and the Healthcare Provider Resource Catalogue, updated October 2009

Guidelines for Healthy Food Selection at Meetings & Events

Indigenous Health

Indigenous Blood Pressure Screening Event Report

This collaborative Report details the learnings and sharings from the Indigenous Blood Pressure Screening Event with the Indigeous Interprofessional Primary Care Team (IIPCT) held November 2020. The Event, led by Kate Brant and Maureen Buchanan, Indigenous Leaders brought together the IIPCT with representatives from the Napanee Area CHC, Ontario Native Women’s Association, Indigenous Diabetes Health Circle (Eastern Region), national Cardiovascular Health Awareness Program (CHAP), and Ontario Renal Network’s chronic kidney disease screening initiative. The session provided an opportunity to learn about the Deseronto Indigenous BP model and discuss key actions for adaptation and spread with Indigenous communities in the south east. 

  • Click Here for the Report

A Stroke Resource for Health Service Providers: A Guide for Working with Indigenous Peoples of Ontario

This is a helpful resource toolkit for healthcare providers developed by the South East Toronto Stroke Network, Central East Stroke Network, Northwestern Ontario Regional Stroke Network, the Ontario Stroke Network and partners. It has information pertaining to Indigenous people's history, their views on health, stroke best practices and other information to help providers caring for Indigenous individuals and their families.

Indigenous health Videos: "As the Rivers Flow: Brain Attack" and "Heartbeat of the Anishnawbe Nation"

These videos utilize Indigenous culture and tradition to describes the pathophysiology and the signs and symptoms of stroke.

Indigenous Healthcare Education and Practice: Applying Digital Teaching and Learning Resources to the Truth and Reconciliation’s Calls to Action

This 2022 collaborative Indigenous community initiative including Queen's University, eCampus, and Northern Ontario School of Medicine has produced a free on-line resource containing virtual educational modules, artwork displaying perspectives on Indigenous healthcare and education, and other digital resources.

  • Click here for the Report
  • Click here for the free Resources including virtual educational modules

Cancer Care Ontario-Aboriginal Relationship and Cultural Competency Courses

Cancer Care Ontario is offering 9 free on-line learning courses to enhance cultural sensitivity for indigenous health. 

Indigenous Resource Guide 

See attached Resource Guide for Indigenous Families that includes Indigenous services and information about community groups and events for Tyendinaga, Deseronto, Napanee, Kingston, Sharbot Lake, and Bancroft areas. 

Vascular Health Resources

The South East LHIN Home and Community Care, the SouthEasthealthline.ca and the Southeastern Ontario Health Collaborative are pleased to announce an on-line resource to help navigate vascular health services for health care professionals working in primary care that brings together vascular health related services or programs into one accessible area.

The site has a home page and a page for each of these three topics:

  1. Vascular Health Promotion-Reducing risk
  2. Managing Vascular Disease-Assessment, treatment and secondary prevention
  3. Living with Vascular Disease-Support services

Vascular Health in Southeastern Ontario

A report on an environmental scan and Think Tanks conducted with primary health care teams across southeastern Ontario summarizing tools, resources and programs in place and top primary care needs in relation to vascular health.

Health Nexus

An organization that supports health care providers capacity to promote health.

Connecting the Dots: A Handbook for Chronic Disease Prevention Through Community Engagement (Health Nexus, 2011)

This handbook is for health professionals, health promoters/ educators, and community groups/organizations who want to work across sectors and with multiple levels to leverage their joint potential to prevent chronic disease in their communities.

Prevention in Hand

This website and mobile application is a resource about chronic disease prevention for health care professionals and the public. The resource was developed by the College of Family Physicians of Canada with the Public Health Agency of Canada. 

C-CHANGE Guidelines

The Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) is a nationally endorsed guideline process that targets primary health care practitioners. Follow this link to access their latest publication.

Canadian Cardiovascular Society

The Canadian Cardiovascular Society website houses a wealth of information including e-guidelines and pocket guides for the following conditions: Atrial Fibrillation, Heart Failure, Dyslipidemia, Antiplatelet Therapy

Diabetes Canada

Diabetes Canada’s Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada represent the best and most current evidence-based clinical practice data for health-care professionals.

Click here for the 2020 Clinical Practice Quick Reference Guide

Secondary Stroke Prevention Mini Webinar Series

This collection of short, focused presentations is designed to highlight the most clinically-relevant information about a variety of topics. Click on the title to watch the recorded presentation:

 

What's new in Secondary Stroke prevention Medications 

Dr. Shirin Jalini, MD- Assistant Professor of Medicine (Neurology) at Queen’s University, Lead for the Kingston Stroke Prevention Clinic

 

Atypical Risk Factors for Stroke 

Dr. Curry Grant, MD- Internal Medicine/ Cardiologist Quinte Health Care

 

Cervical Arterial Dissection 

Dr. Albert Jin MD, PhD, FRCPC- Associate Professor of Medicine (Neurology) at Queen's University, Regional Medical Director for the Stroke Network of Southeastern Ontario.

 

Intracranial Atherosclerotic Disease 

Dr. Anemon Philip, MD- Assistant Professor of Medicine (Neurology) at Queen’s University , Internal Medicine/ Stroke at Kingston Health Sciences Centre

 

Substance Use and Stroke Risk 

Dr. Beth Rubenstein MD- Assistant Professor of Medicine (Family) at Queen’s University, Physician at North Kingston Community Health Centre

 

Medication Adherence- The Ugly Truth 

Aidi Sun, RPh- Pharmacist, North Kingston Community Health Centre

 

Coming Soon!  Atrial Fibrillation

 

Do you have an idea for a topic for a mini-webinar? Let us know- email strokenetworkseo@kingstonhsc.ca