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The Quality of Stroke Care in Canada
Using GOOD data to solve big problems
In all sectors, it is important to have good data. If you’re going to make a difference, you need to know what is going on. You can rely on bits and pieces from Statistics Canada, trade associations or other agencies – or you can go out and collect exactly what you need and set up a system for gathering it.
In June, the Canadian Stroke Network released the first-ever report on the Quality of Stroke Care in Canada.
It was a massive and costly project. It involved:
- putting in place agreements with ten provinces;
- hiring and training nurses to read 10,000 patient charts;
- developing secure data-transfer systems;
- hiring data experts to crunch numbers and reports;
- hiring economists to analyse the findings, and, finally;
- writing and releasing the report at the National Press Theatre and getting it picked up by media outlets across the country.
The Canadian Stroke Network spent about $700,000 to get the full picture of stroke from coast to coast. The project took two years and involved many people.
What can be learned from this exercise?
Only with measurement tools and GOOD data can you possibly know whether you have made an impact.
You can’t improve your sector unless you find out: Has it gotten better or worse? Where are the gaps? Where do we need to focus?
In the case of stroke, we have benchmarks and standards. For the past five years, the Canadian Stroke Network has generated internationally recognized Canadian Best Practice Recommendations for Stroke Care. We have run training courses for health professionals. We have a national strategy to improve care-delivery systems and we have organized an annual Canadian Stroke Congress to put out the best research.
And, now, we have the audit data.
- when we started the Stroke Strategy five years ago, only 2% of Canadian stroke patients were getting the clot-busting drug tPA. The number is now over 20% in some cities – better than anywhere else in the world.
- only 23% of stroke patients are treated in a stroke unit in the hospital. This number is lower than in other countries and we have work to do;
- Only one per cent of stroke patients are benefiting from Telestroke technology – linking stroke specialists with remote hospitals; and
- We could save $36.1 billion in direct and indirect health-care costs over the next 20 years if we improve stroke services.
Five years after the introduction of the Canadian Stroke Strategy, we also know exactly which provinces are lagging behind. We have the information to march into a provincial health minister’s office and describe reality.
We have data to drive the way forward.
Based on the audit data, we are developing a plan to expand Telestroke and access to treatment and rehabilitation; developing a national blood pressure awareness program; and putting in place a research program targeted at identifying vascular risk factors for stroke.
We have a treasury of information and a legacy that will outlive our network.