QHC opened its Integrated Stroke Unit (ISU) for both acute and rehabilitation care a year ago, on Dec 11, 2018. QHC, the designated District Stroke Centre for Quinte, provides inpatient care to stroke patients requiring both acute and rehabilitation services at its Belleville General Hospital site. As such, the hospital had an opportunity to promote a more integrated approach to inpatient stroke care. QHC teams learned from the experiences of other District Stroke Centres such as Peterborough to plan the new unit.
Quinte Health Care Celebrates One Year of Integrated Stroke Unit Care: Improving Stroke Care Through Integration & Teamwork
The Canadian Stroke Congress took place in Ottawa in Oct 2019 bringing together leading stroke experts from across Canada and beyond. Teams delivered presentations and posters to share an impressive array of learning from across the continuum of stroke care within Southeastern Ontario. Dr. Ramana Appireddy delivered an oral presentation on the use of E-Visits in the KHSC Stroke Prevention Clinic as recently published in the Journal of Medical Internet Research: “Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross Sectional Study”.
Work began in the spring to identify core best practice elements and processes that support the stroke patient’s journey with a focus on the transition elements between care settings. The Acute Rehabilitation and Community (ARC) Pathway was developed along with a team self –assessment tool. Each team from acute care to rehabilitation and the community, completed a self-assessment process to review elements that support best practice and facilitate the patient journey.
New evidence (DAWN and DEFUSE 3) indicates that highly selected patients with severe ischemic stroke may benefit from stroke Endovascular Thrombectomy (EVT) between 6-24 hours of clearly defined stroke symptom onset. In response to the extended time window, Emergency Departments and Paramedic Services collaborated with the Stroke Network of Southeastern Ontario to implement the ACT-FAST algorithm. The ACT-FAST is a large vessel occlusion screen for EVT eligibility being used to guide decision making for triaging patients arriving in the Emergency Department.
An Acute Stroke Care Collaborative event on June 26th brought together 24 health care professionals from Stroke Units at Quinte Health Care, Brockville General Hospital, and Kingston Health Sciences Centre. The one-hour event provided an opportunity to receive an update on new stroke best practices, learn about the Integrated Stroke Unit at QHC, and discuss transitions between acute care hospitals. Participants commented on what helped with smooth transitions.
Annual Community Stroke Rehab Program (CSRP) Report Released: 19% increase in CSRP referrals in 2018/19
The annual Community Stroke Rehab Program Report and accompanying Infographic provides an overview of the Community Stroke Rehabilitation Program (CSRP) since service inception in 2009 and reflects the most recent fiscal year data (April 1 – March 31). The Report also includes key reminders for health care providers to ensure optimization of the Program.Key highlights in the 2018/19 report included:447 referrals to the CSRP (a 19% increase from the previous fiscal)Median age ranges of 71 for males and 77 for femalesClients received an average of 15 therapy visitsIncreased number of Communi
Annual Report on Southeast Stroke Support Groups Released: Over 230 stroke survivors and caregivers participated in Stroke Support Groups
The annual Southeastern Ontario Regional Stroke Support Groups Report has been released as well as an Infographic. The Southeast Ontario Stroke Support Groups are funded by the South East LHIN and are all professionally facilitated. Presently, groups are held in Kingston, Sydenham, Napanee, Trenton, Picton, Belleville, Perth and Brockville. Models across the region include stroke survivor, caregiver, couples, social/recreational and transition groups.
Community partners have worked collaboratively to support Adults with Aphasia in the community. In Belleville, Community Care for South Hastings and Quinte & District Rehabilitation have partnered to provide the Belleville Aphasia Conversation Group (ACG); VON Greater Kingston (VON) has partnered with Kaymar Rehabilitation Inc.
The following are offered free from the Apasia Institute:Introduction to Supported Conversation for Adults with Aphasia (SCA™) eLearning: A short self-paced online module. It includes practical and video examples of concrete techniques using the evidence-based method called Supported Conversation for Adults with Aphasia (SCATM).
The Regional and KHSC Stroke Teams are pleased to warmly welcome Jennifer Holliday as our new part time Stroke Specialist Case Manager. Jennifer is just completing her orientation to the role and will work closely with Anne Dubé, full time Stroke Specialist Case Manager and with the full stroke team. Jennifer’s nursing career began in 2004 with a nursing diploma from St Lawrence College in Kingston. In 2018, she received a Bachelor of Science in Nursing from St.
Transforming Care Together: Several top performers highlighted in annual South East Stroke Report Card
A recently released provincial report indicates that patient and families from across the South East Local Health Integration Network (LHIN) are benefiting from ongoing improvements in access to hyperacute treatment and stroke unit care and home-based community rehabilitation. According to new data released by CorHealth Ontario, the SE Report Card and related Infographic highlight the SE Region as an exemplary performer in several key areas:High Thrombolysis ratesFastest Median door-to-needle time in the province; KHSC-KGH was listed as the top provincial performer at 24 minutesHigh access
To further support transitions from acute stroke units and respond to patient and provider feedback, a pilot of referrals to the South East LHIN’s Rapid Response Nurse (RRN) program, in conjunction with referrals being made to the South East LHIN’s Community Stroke Rehabilitation Program occurred between October 2017 and March 2019. Evaluations demonstrated that RRN interventions improved medication management and linkages to primary care as well as supportingpatients and families through education and connections to relevant resources.
Working with the Stroke Network’s Community Reintegration Leadership Team, a Patient Journey Map has been created. This map visually displays the recovery journey following a stroke beginning with the stroke event and moving through acute, rehab and community care. The map is intended to reflect a diversity of patient journeys to stimulate and support conversations between patients/families and clinicians. A handout of the Patient Journey Map includes a listing of potential resources on the reverse side. This can be used by clinicians to provide the patient and family with a better under
Returning to driving after a stroke can be a complicated and costly endeavor for stroke survivors and their families. Understanding the rationale for suspending a driver’s licence and the process involved in a return to driving is imperative as the stroke survivor and family adapt to a changed life situationThis southeast Driving After a Stroke in Ontario resource is intended to help stroke survivors (and families) connect with supports and services that can assist them during the process of returning to driving. The resource also recognizes that not all stroke survivors will be able to r
We are delighted to welcome Heather Jenkins to the role of Regional Stroke Education Coordinator with the Stroke Network of Southeastern Ontario.Heather obtained a Bachelor of Science in Biochemistry from Memorial University NFLD in 1999, followed by a Bachelor of Science in Physical Therapy from Queen’s University in 2002.
Raising the Bar: Kingston Health Sciences Centre-Kingston General Hospital Site received its Third Accreditation Canada Stroke Distinction Award
KHSC achieved its third Stroke Distinction award! The 2018 Accreditation Canada Report highlighted many strengths. There were more standards to meet this time round and the results were positive. KHSC sustained achievement of performance indicator targets despite growing patient volumes. A greater number of criteria were achieved for patient and family education and each of the 14 protocols were demonstrated, an increase from last survey. KHSC received extremely positive feedback on implementing 24/7 access to Endovascular Thrombectomy across the region.
January 2019 saw the first session of the pilot Kingston-based community Aphasia Conversation Groups. A Kingston-based Aphasia Buddies Program also began providing services in January through the VON-Kingston.Funded by the South East LHIN, the Aphasia Conversation Groups are facilitated by a speech-language pathologist (SLP) from Kaymar Rehabilitation and coordinated by the VON Stroke Support Coordinator.
New Provincial Resources Released to Enhance Implementation of Secondary Stroke Prevention Best Practices
A provincial workgroup of clinical experts was tasked with updating the Stroke Prevention Clinic Model of care in Ontario. The workgroup identified resources including strategies to implement best practice core elements in Secondary Stroke Prevention Clinics and to enhance system-wide performance and outcomes for people with TIA and stroke. The work has been completed and the compilation of resources was released on January 30th.
Community and Outpatient Stroke Rehabilitation Provincial Workgroup Report Stroke rehabilitation in the community and outpatient setting was identified as a provincial priority by the eleven regional stroke networks in Fall 2016 and the following resources are now available here A resource tool outlining methodology to do an estimate demands analysis for stroke outpatient/community rehabilitative services based on a region's own geography.Summary of common emerging facilitators and change ideas that outpatient (OP) programs have implemented to meet stroke best practices.A decision mak