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Stroke Progress December 2015

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In this edition

Stroke care not up to standard

Acute stroke care quality in Australia has stagnated, according to the National Stroke Foundation 2015 Acute Services Audit. Launched at The Royal Melbourne Hospital earlier this month, the Audit revealed that espite significant advancements in the treatment and care for stroke, patients were still being denied best practice care in Australia. 

In saying this, the Audit also found there was significant opportunity for improvements across the country through tailored strategies which could impact on the quality of care provided. 

The Audit at a glance:

  • 185 hospitals surveyed, 4,087 patient cases audited.
  • Around 30,000 stroke patients a year.
  • 87 hospitals with a stroke unit.
  • 16 have no medical stroke lead.
  • 11 have 24/7 endovascular (clot retrieval) treatment.
  • One qualifies as a comprehensive stroke service.
  • Almost 20,000 patients a year were denied the full benefit of stroke unit care.
  • 7% of ischemic stroke patients receiving thrombolysis – unchanged since the 2007 Audit.
  • 44% of patients are being discharged with no care plan.
  • 1/3 of patients are discharged with no prevention medication.

The 2015 National Stroke Audit presents data central to understanding the nature of current acute stroke services in Australia. It tracks the performance of Australia’s stroke care against best practice guidelines: the Acute Services Framework 2015 and for the first time the Australian Commission on Safety and Quality in Health Care (ASQHC) Acute Stroke Care Clinical Standard 2015.

It is important to note there were some demonstrated improvements in Queensland and South Australia where there had been a focus on the quality of stroke services. This showed that with investment in planning and delivery of stroke services, as well as education of health professionals, patient outcomes will improve.

Key recommendations of the Audit included:

  • Concentrating efforts on where they will have the greatest impact by ensuring comprehensive stroke services are available in every capital city.
  • Stroke units must be appropriately resourced with the right multidisciplinary care teams, systems and support to deliver high quality care.

In response to the Audit, the National Stroke Foundation is calling for an initial government investment of $40 million to urgently address the gaps in stroke treatment and care identified. There must also be a commitment from all governments to develop detailed costings for a national action plan to close the care gaps permanently. Initial focus should be on improved follow up programs for stroke survivors on their return home and regular monitoring of stroke care. 

National Stroke Foundation would like to thank all who contributed to the Audit. It is only with this support we are able to gain this insight into stroke care across the country and drive quality improvement. Individual site reports will be provided into the New Year. 

Key findings, full report and recommendations of the National Stroke Audit Acute Services 2015

Write to the Federal Health Minister in support of National Stroke Foundation’s ask.

National Stroke Foundation appoints new Chief Executive Officer

We are pleased to announce Sharon McGowan has been appointed to the role of Chief Executive Officer. Sharon joins the National Stroke Foundation from Melbourne

Health where she has held the role of Executive Director Communications and Community Relations since 2010. 

In this role Sharon was responsible for Communications, Community Engagement, Culture Transformation program, Health Promotion, Fundraising and the Volunteer Service. Here, Sharon managed 20 team members, 400 plus volunteers and a budget of circa $20m. In addition, Sharon was executive sponsor of three Board sub-committees – Community Advisory Committee, Population Health and Primary Care Committee, and The Royal Melbourne Hospital Foundation Committee.

Sharon has worked both in Australia and the UK. Originally trained as a registered nurse, she has held senior roles at Benetas where she was Deputy CEO, Australian Red Cross Blood Service and the National Blood Service in the UK. Sharon has an MBA from Cranfield University and is a graduate of the Australian Institute of Company Directors. 

Sharon will begin her new role at the National Stroke Foundation on Monday 1 February 2016.

If you have any queries please do not hesitate to contact admin@strokefoundation.com.au

InformMe – We want your help

informme

As you are aware, the National Stroke Foundation is working hard to deliver a new website for health professionals working in stroke care. InformMe, launching in early 2016, will provide a consolidated user-centered resource for health professionals to assist you in delivering the best possible treatment of stroke care.
We want to ensure that InformMe best meets the needs of health professionals working in stroke. Which is where we need your help. We’re looking for volunteers to test the site before it goes live. Key areas you would be helping to refine and improve include:

  • Membership area -  Individualised information and features including a step-by-step guide to developing a quality improvement plan
  • Guidelines Clinical - Guidelines in Stroke Management 2010 and other key guidelines for stroke
  • Learning & resources  - Professional development modules, emerging evidence, and resources for stroke care broken down by topic areas 
  • Stroke data - NSF audit results including national and individual site reports 
  • Collaboration - Member area for collaboration such as “Ask a question” and resource sharing
  • Improving care - Information and guidance on implementing clinical improvement in stroke care

To be involved drop us a line at informme@strokefoundation.com.au 

While InformMe is under development, resources continue to be available on the National Stroke Foundation and eStroke websites.

Guidelines update kicks off

The update of the stroke clinical guidelines is well and truly underway. In September the advisory committee and content working group set the direction of the update. The advisory committee is chaired by University of Sydney’s Professor Richard Lindley with the content working group co-chaired by The Royal Melbourne Hospital’s Dr Bruce Campbell, and University of Newcastle’s Assoc Prof Coralie English. The process will follow the guidelines for developing clinical practice guideline standards as determined by the National Health and Research Medical Council. The working group has agreed on the questions to be included in the literature search which is almost complete, with the evidence review well underway.

Excitingly we are working with international stroke experts, with New Zealand clinicians directly involved in the guidelines update and Norwegian health professionals collaborating both on guideline content and new technology to enable the guidelines to be delivered electronically. Keep your eyes peeled for more updates on this exciting work in the New Year.

For more information about the guidelines contact Leah Wright guidelines@strokefoundation.com.au

Stride for Stroke wrap up

Last month, thousands of Australians laced up their running shoes and pounded the pavement in a massive effort to kick stroke to the curb. A huge thanks to
everyone who took part. Collectively we strode more than 78,000 kilometres and raised an astonishing $200,000 towards the fight against stroke.

This year a number of health professionals signed up to Stride for Stroke. Out of the top ten fundraising teams, more than half were stroke pros. Team Stroke Coast Busters from the Central Coast, was one of the teams on the list. These 11 committed health professionals strode more than 1400 kilometres and raised an
impressive total of more than $3,600. Team captain and Area Stroke and Neurology Coordinator Justine Watkins said the team was inspired by its patients. 

“We see first-hand the effects of stroke every day in our workplace, so we joined Stride for Stroke because we wanted to make a difference and support the National Stroke Foundation,” she said.  Another team taking the challenge in their stride was Team RPA from the Royal Prince Alfred Hospital in Sydney. Team RPA was inspired by former stroke patient Victoria, who strode alongside the health professionals who treated her last year. Together the team strode almost 5000 kilometres and smashed their fundraising goal of $720, raising more than $4,800! 

We’re so grateful to everyone who got involved in Stride for Stroke this year – thank you for your ongoing amazing support.

Meet the 2015 Stroke Care Champion

The National Stroke Foundation recently announced the winners of the 2015 Stroke Awards. We received more than 60 nominations and the calibre of entries was truly outstanding, thank you to everyone who made a nomination. As in previous years, the 2015 Awards included a category dedicated to health professionals
working in stroke – the Stroke Care Champion Award. 

This year Dr Rohan Grimley took out top honours in this category. Dr Rohan is pictured below on the right with Greg Cadigan, his nominator. As head of the Queensland Clinical Stroke Network, the passionate geriatrician and stroke physician has driven astonishing improvements in access to stroke unit care in the State.

In a period of less than 10 years, stroke unit access in Queensland has increased from 40% to over 80% with countless people being saved from death or severe disability as a result. Rohan is also passionate about using systematic data collection in stroke to drive improvement in care at a local, state and national level.
In addition to his work driving systematic change in acute stroke care in Queensland, Rohan volunteers his time delivering stroke awareness talks in the community, helping to educate people about stroke and the steps they can take to recognise and prevent it. 

Rohan’s passion, dedication, vision and energy is inspirational. Dr Rohan Grimley is a true stroke champion and is much deserving of the title of the 2015 Stroke Care Champion. For more information visit the 2015 Stroke Awards winners and finalists.

rohan

National Stroke Foundation greenlights exciting new stroke research

Eleven exciting new stroke research projects have been given the green light as part of the National Stroke Foundation’s annual grants program. 

The Foundation will provide more than $312,000 to Australian researchers to conduct vital research in an effort to prevent stroke and improve the quality of life of stroke survivors, their families and carers. The new research projects, announced this week, have the potential to influence important change in stroke practice, policy and knowledge. 

This latest round of grants cover priority research areas, including improving the delivery of high quality stroke care, transitioning patients from the acute setting into the community and management of fatigue.

Excitingly many of the funded projects are looking at how new and emerging technology can help stroke patients, giving us great hope for the future of stroke care in this country. 

Projects funded through the 2016 grants round include an evaluation of the FAST signs of stroke awareness campaign; and research into acute care of culturally and linguistically diverse stroke survivors. 

Other funded projects include a feasibility study of a culturally appropriate rehabilitation model for Aboriginal and Torres Strait Islander stroke patients and a smart phone rehabilitation app for stroke survivors with aphasia. 

We had a fantastic response to the call for the 2016 grants round with 55 applications received overall, thank you to everyone who submitted an application. We can’t wait to see the outcomes of these exciting new projects.

To see more information about the 2016 grant recipients, our grants process, past grant recipients and project titles please check out the research page on our website.

If you have any questions regarding the research program please contact us at research@strokefoundation.com.au

Honours abound for stroke professionals 

The achievements of Monash academics were celebrated at the Monash University Vice-Chancellor’s Education and Research Awards Program ceremony on Tuesday 17 November 2015. 

Associated Professor Dominique Cadilhac was presented with the Award for Research Impact. 

Congratulations Dominique, pictured below on the right receiving her award.

educ-award

Congratulations also to Dr Bruce Campbell, Associate Professor Peter Mitchell and the rest of the team at The Royal Melbourne Hospital who were recently named the gold winners in the 2015 Victorian Public Healthcare Awards in the category for Improving healthcare through clinical research.

Finally congratulations to Professor Chris Levi and the Hunter Stroke team (pictured below with NSW Health Minister Jillian Skinner) for receiving the Translational Research Award for Transforming acute stroke care locally and globally at the 2015 NSW Health Awards.

healthaward

Let us know if you or your team has won an award as we love sharing the great work being done in the stroke community.

enableme 

enablemelogo

One of the most common questions we get asked about enableme is whether the site is moderated. The short answer is yes, it is. Diana Kerr is the National Stroke
Foundation’s Online Community Coordinator. She has been coordinating our social media communities, including Facebook, since 2010. We asked her about her
experience working with the enableme community. 

What is a Community Coordinator?

It’s a bit like being a dinner party host. My job includes welcoming people, introducing people who may have common interests, prompting conversation, suggesting
topics and filling those awkward silences. Mostly it involves working behind the scenes: nobody wants to see the work that goes on. It should look effortless, just like a great dinner party.

What does your work on enableme involve?

A big part of my role is building the trust with the community and nurturing its natural leaders. A lot of it is about enabling the people who really understand life after
stroke, because they are living it. You have to nurture those relationships because you will need to call on them
at times. 

I also work closely with the health professionals from the StrokeLine team, who provide advice and assistance when we think someone is vulnerable or at risk. They also provide their perspective on conversations about stroke deficits and their treatment and management.

What’s the enableme community like?

The enableme community is in its infancy. Our Facebook community was quicker to build because people were already there using Facebook. enableme is about moving people to a new destination and helping them form new habits. This takes a bit longer but it is nice to see our early adopters are becoming its champions.
When you hear about online communities, it’s often about trolls and people looking to make sales. Our community isn’t like that. They have a common experience and are supportive of each other. There’s a lot of debate and difference of opinion, but it’s based on mutual respect.

What conversations are happening on enableme?

People ask the questions they need to as they progress in their recovery. SaeboFlex is a hot topic at the moment, and is a good example of stroke survivors sharing their experiences and health professionals sharing their expertise. There are lots of conversations too about what it means to survive a stroke and to work towards recovery. 

The forum “Why is plateau such a dirty word?” is a great example of a conversation about the meaning of recovery, and the balance between striving for as much recovery as possible and accepting life as it is now. Recovery is different for everyone, which makes for great conversation.
Diana is pictured above with Richard Cullen who created the enableme website.

Australian Stroke Coalition update

The Australian Stroke Coalition (ASC) recently met in Melbourne for its second and final face to face meeting for 2015. A number of key work areas were discussed:

Data and Quality working group 

In line with the ASC’s vision to improve the quality of stroke data to drive improved quality of stroke care, the working group is looking at broadening the use of the Australian Stroke Data Tool (AuSDaT). Launched in June this year to support data entry for the Acute Services Audit, the working group has now approved an
implementation strategy for moving other program users over to the AuSDaT, with the current focus on supporting Australian Stroke Clinical Registry (AuSCR) to transition by mid-2016.

Excitingly, the Queensland Government has signed a three year, $1.5 million stroke agreement to help this work, which includes funds for the AuSDaT tool, AuSCR and integrating the National Stroke Foundation’s StrokeLink quality improvement program.

Access to rehabilitation for acute stroke patients

Last year the ASC agreed on a new priority: helping to collect information to better understand the gap between patients who need rehabilitation and those who are able to access it. 

South Australia has now completed research into this, with key findings showing that about 16% of patients were not referred to rehab, and of that group, about 16% had no documented reason for this. The group is currently examining a number of options to further this important work.

ASC evaluation survey results and 2016 work plan

Earlier in the year, ASC members were surveyed on their views about the coalition, how it could be improved and potential future focus areas for the group. The evaluation found that overall, the group was meeting its aims, and members were largely supportive of the ASC as a forum to learn about the efforts of other jurisdictions, play a role in ASC decision making, and contribute to a nationally representative voice for stroke. 

Member feedback on future activities of the ASC focussed on three key themes: rehabilitation and ongoing care for stroke survivors; data collection and quality improvement; and better access to quality care for all patients, regardless of location.

Members discussed a range of activities happening across the country, and where future effort could be best invested. Building on the work done by South Australia in the access to rehabilitation space, Queensland has put forward a potential project to improve access to rehabilitation by linking data from the acute to sub-acute sector, which could be expanded to a national level with the assistance of the ASC. 

Member reports 

The ASC has re-introduced member reports, where each member organisation has the opportunity to provide an update of key organisational activities and challenges relevant to stroke. This was extremely successful, with many member organisations sharing key information and agreeing to have further discussions on certain
issues offline. It was agreed member updates should be a regular part of all future face to face ASC meetings.

For more information on the work of the ASC, contact Executive Officer Kate Leonard at admin@strokefoundation.com.au or phone 03 9918 7209.