OPTIMISING stroke treatment process

The objective of OPTIMISING ACCESS is to ensure the highest level of quality in the treatment of acute ischemic stroke patients with both thrombolysis and endovascular thrombectomy (EVT) across Canada, with the aim to reduce disparity between rural/remote and urban hospitals.

The aim of OPTIMISING ACCESS will be achieved by:

  1. Development of a national registry for acute stroke treatment that will be deployed to all stroke hospitals across Canada, which will ensure key process, clinical, and demographic data is collected for all patients that receive treatment. This will include process information about thrombolysis and EVT treatment including process information for those patients that are transferred for EVT from a centre that is only capable of thrombolysis treatment.

  2. Assessment of disparity between patients arriving first to an EVT centre compared to those arriving first to a peripheral stroke centre that is only capable of thrombolysis treatment. Regional transfer efficiencies will also be assessed to better understand the delays in transfer across Canada.

  3. Improvement of access to EVT & transfer efficiency for EVT - improve the proportion of patients that receive EVT when first presenting to a peripheral stroke centre; reduce the time spent in the peripheral centre (Door-In-Door-Out time); reduce the time to arrival at the EVT centre (Door-In-Door-In time).

With an aim to rollout the registry to over 200 stroke hospitals in Canada and conducting national improvement projects, an estimated 40% increase in EVT cases would be enabled through improved access to treatment, resulting in an additional 1500 EVT cases/year and an additional 300 patients every year who will be disability free.