(Press-News.org) A new model for stroke care is being studied in rural Alberta to reduce inequities in health across communities. This model, presented at the Canadian Stroke Congress, shows how hospitals in rural areas can mimic the type of care that's often only available in larger centres.
In geographically diverse Canada, stroke care can seem like tale of two cities – or more like a city and a small town. The ideal is stroke unit care, where a multidisciplinary staff of doctors, nurses and therapists collaborate on treatment and the road to recovery. In Alberta, that type of care is only offered to 52 per cent of patients, mainly in urban settings. The proportion is lower in many other provinces. Frequently, hospitals in smaller centres just don't have the same resources.
"There are challenges in these smaller centres, mainly because of a lack of sub-specialists, dedicated beds or early exposure to therapists," says Dr. Thomas Jeerakathil, stroke neurologist and co-chair for the Stroke Action Plan project, which is funded by the Cardiovascular Health & Stroke Strategic Clinical Network, Alberta Health Services. "What we're trying to do is replicate the experience of stroke unit care for rural and smaller urban areas."
The study received the Canadian Stroke Congress Co-Chairs Award for Impact.
The model described in the study starts with SUEC, which stands for Stroke Unit Equivalent Care. "You train staff to have additional expertise in stroke, have standardized orders and pathways, which are protocols that are followed, and increase rehabilitation staffing," says Dr. Jeerakathil.
In the smaller hospitals, stroke patients should all consistently be admitted to the same ward. The idea is that over time staff there will develop greater proficiencies in responding to these patients.
Another key element in the Alberta model is early supported discharge (ESD). Currently, only 14 to 19 per cent of stroke patients receive intensive rehabilitation upon discharge. Dr. Jeerakathil suggests that ESD has the potential to expand intensive home-based rehab to another 30 per cent of stroke patients.
With ESD, stroke patients who don't need in-patient nursing, and who aren't medically fragile, go home from hospital sooner once plans are in place for caregiver and other support. That might include frequent visits from a physiotherapist or occupational therapist at home to meet the patient's rehabilitation needs. ESD is used in Edmonton and Calgary as well as in larger centres in other provinces such as Ontario, and is being expanded to small urban areas as part of the project.
The third service-delivery method integrated into the model is community rehabilitation (CR). Sometimes, patients living with the residual effects of a stroke may fare well for a time then decline. CR looks to catch people like that, with followup for medical attention and monitoring, and perhaps a refresher course in rehab.
The SUEC model has been implemented at 14 rural centres, with ESD and CR in five of those. "We're seeing the results in terms of decreasing length of stay, the increasing number of patients with access to rehab and increased patient satisfaction," says Agnes Joyce, presenting author and manager of the Cardiovascular Health & Stroke Strategic Clinical Network.
Hot Topic in Stroke: Rural Care
"With strokes, as with other disease states, it's essential to minimize the urban-rural discrepancies we see sometimes in access to care," says Patrice Lindsay, director of stroke best practices and performance for the Heart and Stroke Foundation. "The Alberta project highlights how it's possible to raise the bar at smaller sites and align their care with best practices."
In Alberta, Dr. Jeerakathil also points to the benefits of telestroke as an effective way to deliver care to stroke patients anywhere. Telestroke uses telecommunication technology to link referring and consulting healthcare sites for real-time assessment and management. That provides stroke patients with extended access to a variety of treatments and services.
"Telestroke is underused," says Lindsay. "In a country the size of Canada, we have to be creative in finding ways to spread the best care to smaller communities, resulting in consistent services and ultimately the best outcomes."
The model developed in Alberta could be transferred to other provinces and have a dramatic impact on stroke care and outcomes across Canada.
Research Creates Survivors
Elwood Kirkpatrick, is a "grateful recipient of a great project" and one of the first patients at the ESD site launched in Red Deer, Alta. He wants everyone to know about early support discharge, which allowed him to return home sooner, where he then received one-on-one rehabilitation support. "It is quite a great service for citizens like me and others in this community."
INFORMATION:
The Canadian Stroke Congress is co-hosted by the Heart and Stroke Foundation and the Canadian Stroke Consortium.
Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect HSF or CSC policy or position. The Heart and Stroke Foundation and the Canadian Stroke Consortium make no representation or warranty as to their accuracy or reliability.
About the Heart and Stroke Foundation
The Heart and Stroke Foundation's mission is to prevent disease, save lives and promote recovery. A volunteer-based health charity, we strive to tangibly improve the health of every Canadian family, every day. Healthy lives free of heart disease and stroke. Together we will make it happen. heartandstroke.ca
Congress information and media registration is at http://www.strokecongress.ca
After October 7, 2014, contact:
Jane-Diane Fraser
Heart and Stroke Foundation of Canada
jfraser@hsf.ca
613-691-4020
People who have had a stroke or transient ischemic attack (TIA or mini-stroke) are at high risk for a second similar event or other serious medical problems for at least five years and need better follow up and strategies to prevent these problems, according to data presented at the Canadian Stroke Congress.
At present, most stroke or TIA patients in Canada are followed closely by specialty clinics for about 90 days after an event, during the period they are considered at highest risk for a repeat event. If no such incident occurs during that period, they are often transferred ...
WASHINGTON, DC – October 7, 2014 -- Yogurt containing probiotic bacteria successfully protected children and pregnant women against heavy metal exposure in a recent study. Working with funding from the Bill and Melinda Gates Foundation, Canadian and Tanzanian researchers created and distributed a special yogurt containing Lactobacillus rhamnosus bacteria and observed the outcomes against a control group. The work is published this week in mBio, the online open-access journal of the American Society for Microbiology.
A research team from the Canadian Centre for Human ...
Targets to eliminate tuberculosis (TB) by 2050 are more likely to be met if new vaccines are developed for adults and adolescents instead of for infants, according to new research published in the journal Proceedings of the National Academy of Sciences.
Researchers at the London School of Hygiene & Tropical Medicine and the Stop TB Department at the World Health Organization found that a vaccine given to adolescents and adults in low- and middle-income countries could have a much larger impact on the burden of TB worldwide and is more likely to be cost-effective, even ...
Tiny vesicles containing protective substances which they transmit to nerve cells apparently play an important role in the functioning of neurons. As cell biologists at Johannes Gutenberg University Mainz (JGU) have discovered, nerve cells can enlist the aid of mini-vesicles of neighboring glial cells to defend themselves against stress and other potentially detrimental factors. These vesicles, called exosomes, appear to stimulate the neurons on various levels: they influence electrical stimulus conduction, biochemical signal transfer, and gene regulation. Exosomes are ...
New Rochelle, NY, October 6, 2014—Self-management of diabetes, including medication, nutrition, and lifestyle strategies, is essential for optimal glycemic control and minimizing complications of the disease. Education to teach and improve self-management skills is critical for success and, when delivered via the Internet, can lead to better glycemic control and enhanced diabetes knowledge compared to usual care, according to a Review article in Diabetes Technology & Therapeutics (DTT), a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is ...
ALLENDALE, Mich. — Even among contemporary U.S. distance runners, men are still much more likely than women to have a competitive orientation, according to researchers at Grand Valley State University in Allendale, Michigan. The findings were published in the online journal, Evolutionary Psychology at http://www.epjournal.net/articles/u-s-masters-track-participation-reveals-a-stable-sex-difference-in-competitiveness/
The new research, led by Robert Deaner, associate professor of psychology at Grand Valley State, shows that, on average, American men participate at ...
Imagine being able to take a pill that lets you eat all of the ice cream, cookies, and cakes that you wanted – without gaining any weight.
New research from USC suggests that dream may not be impossible. A team of scientists led by Sean Curran of the USC Davis School of Gerontology and the Keck School of Medicine of USC found a new way to suppress the obesity that accompanies a high-sugar diet, pinning it down to a key gene that pharmaceutical companies have already developed drugs to target.
So far, Curran's work has been solely on the worm Caenorhabditis elegans ...
New Rochelle, NY, October 6, 2014—While poker is a game of chance, there is skill and decision-making involved, and the quality of those decisions depends on both knowledge of the game and the ability to control one's emotions. The results of a new study that evaluates emotionality, experience level, and success among online poker players are presented in Cyberpsychology, Behavior, and Social Networking, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available free on the Cyberpsychology, Behavior, and Social Networking website until ...
COLUMBUS, Ohio – Majorities of media researchers, parents and pediatricians agree that exposure to violent media can increase aggression in children, according to a new national study.
The study found that 66 percent of researchers, 67 percent of parents and 90 percent of pediatricians agree or strongly agree that violent video games can increase aggressive behavior among children.
Majorities of these groups also believed that children's aggressive behavior can be fueled by viewing violent video games, movies, TV programs, and Internet sites. However, fewer than ...
Imagine being able to tune the properties of a solid material just by flashing pulses of light on it, for example turning an insulator into a superconductor. That is just one potential payoff down-the-road from the physical phenomenon of electrons and atoms interacting with ultrashort pulses of light. The technology of ultrafast spectroscopy is a key to understanding this phenomenon and now a new wrinkle to that technology has been introduced by Berkeley Lab researchers.
In a study led by Alessandra Lanzara of Berkeley Lab's Materials Sciences Division, time- and angle-resolved ...