Canadian Stroke Network
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Canadian Stroke Network

Accreditation Canada: Stroke Services
Recognizing stroke services that are worthy of Distinction

From the inception of the Canadian Stroke Strategy, the CSN’s goal has been to work with Accreditation Canada on a program that would integrate stroke best practices and stroke system monitoring into current accreditation programs. We are pleased that the “Stroke Distinction” program — the first disease-specific accreditation effort in Canada — was recently introduced.

In September 2009, six health-care centres across the country participated in pilot testing the program. Stroke Distinction measures hospital performance against the Canadian Best Practice Recommendations for Stroke Care, first released by CSN and HSFC in 2006 and updated in 2008. Centres that took part in the pilot testing include Saint John Regional Hospital, Centre hospitalier de l’Université de Montréal, Toronto Rehabilitation Institute, Hamilton Health Sciences, Regina Qu’Appelle Health Authority and the Calgary Stroke Program.

The plan is to roll out the voluntary program on a national scale in 2010. And none too soon. While the number of strokes in Canada is high – 50,000 a year – the incidence of the disease will get worse as the population ages. The risk of stroke doubles every decade after age 55. (3) The proportion of seniors in Canada will reach 25 per cent by 2031, double their current level of 13 per cent. (4) That alone implies a four-fold increase in the incidence of stroke over the next 20 years.

“For us, this is such an important way to operationalize the Canadian Best Practice Recommendations for Stroke Care,” says Patrice Lindsay, the CSN’s Performance and Standards specialist, who has worked closely on the development of the accreditation program. She says the initiative will provide a “strong way to get attention for stroke at the local and provincial levels” and it will “acknowledge what is being accomplished.”
As part of the two-day accreditation process, on-site evaluators, who are experts in the field of stroke, examine services in the areas of:

  • Overall stroke services: acute services including beds and volumes, inpatient rehabilitation beds;
  • Acute stroke services: Stroke units, interdisciplinary teams, functional relationship with EMS, the use of acute thrombolytic therapy, diagnostic neurological services, access to timely CT scans; neurosurgical services;
  • Inpatient Rehabilitation services: Interdisciplinary teams, stroke units, approach to managing patients, length of stay and access to outpatient services;
  • Stroke protocols: protocols in place for stroke services, consistent implementation of stroke protocols, client and family education, case management and transition planning.
  • Secondary prevention clinics: services at secondary prevention clinics, referrals to secondary prevention clinics; and,
  • Technology: Telemedicine for stroke services and telemedicine for clients.

Following the on-site visit, Accreditation Canada generates a full report that outlines areas of strength and areas that need further improvement. Stroke Distinction designation remains valid for two years.

“The purpose of Stroke Designation is to provide health service organizations with a voluntary and rigorous review process that recognizes health service organizations that have demonstrated an outstanding commitment to excellence and improving client outcomes in stroke,” says Wendy Nicklin, president and CEO of Accreditation Canada.

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