Stroke Unit Certification Program

Access to a dedicated hospital stroke unit makes the biggest overall difference to outcomes in patients who present with stroke. A stroke unit is a facility in which medical, nursing and allied health professionals with expertise in stroke provide coordinated care in a geographically co-located environment.

With stroke unit care a powerful intervention to improve stroke outcomes, stroke unit certification is recommended by the World Health Organization, the World Stroke Organization and the Australian Government’s National Strategic Action Plan for Heart Disease and Stroke, as a quality assurance and improvement activity.

The Australian Stroke Coalition (ASC), co-chaired by Stroke Foundation and the Stroke Society of Australasia, developed a voluntary system for certification of acute stroke units that commenced with Australian sites as a 12-month pilot program in July 2022.

How certification works

The certification process involves:

• a facilitated application
• documentation and data evaluation
• an online Zoom review and virtual site walk-through by a panel of two adjudicators (one medical and one nursing or allied health) and the Stroke Unit Certification Project Officer
• final approval by a national committee.

Voting members of the committee, chaired by Professor Tim Kleinig, comprise clinical leads from each state and territory, as well as nursing, allied health and consumer representatives.

For sites that meet the criteria, Stroke Unit Certification is awarded for a period of 4 years. Sites identified as being able to meet the criteria with support are granted Provisional Approval for a period of 12 months, to enable follow-up of recommended areas before full approval can be granted. Sites identified as unable to meet the criteria within 12 months are not granted certification and are provided with support and guidance to improve their standard of stroke care.

The aim is for sites to use this process to consolidate and strengthen local efforts or help build a case for more resources. All sites which achieve certification receive valuable feedback as part of the review process, which can be used to further strengthen their services.

How certification has helped

The initial 12 months of the ASC Stroke Unit Certification pilot program received strong interest from many sites across the country, and support from the Australian stroke community. The 11 sites who successfully completed the full review process and achieved certification are listed below, with certification now continuing in acute stroke unit sites across the country.

Participating sites have reported the application and feedback process has contributed to positive changes in their stroke care, notably around quality improvement, job descriptions and roles, and nursing interventions. Feedback from sites to date includes:

• “The process is valuable. 'What is seen is managed,' so the full assessment provides an opportunity to see the areas that can be celebrated and those that require attention.”
• “I didn't think the process was difficult or time consuming and it allowed us to see where we could improve because there is always room for improvement.”
• “It enabled us to review our service and we will now use the recommendations from the accreditation to review our process.”
• “Stroke unit certification has enabled momentum of quality improvement.”
• “Has provided recognition to a service that is sometimes overlooked.”
• “Really positive to have a full review of this process.”
• “I would strongly encourage all facilities to participate.”
   

Australian sites are encouraged to register interest in certification.

For more information on the ASC’s Stroke Unit Certification Project, please contact Senior Project Officer Leah Pett: lpett@strokefoundation.org.au

Certified sites