Report recommends specialised stroke services

Report recommends all DHBs provide specialised stroke services

Stroke Foundation media release 20 December 2010

A major new report on the management of stroke says all District Health Boards (DHBs) should provide organised stroke services.

Mark Vivian, CEO of the Stroke Foundation says currently, stroke services provided in many DHBs fall well short of that standard, with fewer than half having dedicated stroke units.

“An audit of stroke services carried out for the Ministry of Health earlier this year found there were only eight dedicated stroke units in the then 21 DHBs. There were a total of only 83 beds dedicated to stroke patients nationwide.

“On the day of the audit, there were 176 acute stroke patients in New Zealand hospitals, and only 39 percent were in stroke units.”

The report Clinical Guidelines for Stroke Management 2010, released today, is from the Stroke Foundation of New Zealand, developed in collaboration with the New Zealand Guidelines Group and the Australian National Stroke Foundation, with input from Maori and Pacific advisory groups.

It recommends that all people admitted to hospital with stroke should expect to be managed in a stroke unit by a team of health practitioners with expertise in stroke and rehabilitation.

Dr John Fink, Medical Director of the Stroke Foundation and the report’s primary author, says the guidelines provide a comprehensive review of the latest international research about the management of stroke. They provide detailed, evidence-based guidance on the management of all aspects of stroke – including prevention, pre-hospital care, acute care, community care and TIA (mini-strokes).

Mr Vivian urges DHBs to adopt the guidelines. “If implemented these guidelines provide a template for improved treatment of patients and the means to reduce the annual cost of stroke in New Zealand.

“Strokes currently cost this country about $450 million each year, and this is estimated to increase to $700 million by 2015. Putting in place these guidelines would see people receiving the best possible care for stroke, as quickly as possible, by a medical team that specialises in the management of stroke.

“Lives would be saved, and stroke survivors would suffer less severe damage to the brain and have a shortened rehabilitation time.”

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Report recommendations

Clinical Guidelines for Stroke Management 2010 are intended for use by health practitioners, administrators, funders and policy makers who plan, organise or deliver care for people with stroke during any phase of recovery from stroke or TIA.

Provision of stroke services

·         All District Health Boards (DHBs) should provide organised stroke services.

·         All people admitted to hospital with stroke should expect to be managed in a stroke unit by a team of health practitioners with expertise in stroke and rehabilitation.

·         Large and medium-sized DHBs should provide an acute stroke thrombolysis service for their populations.

·         All DHBs should provide a transient ischaemic attack (TIA) service in accordance with the NZ TIA Guideline (2008).

·         Large DHBs can provide organised stroke-specific community teams.

·         Maori and Pacific participation in decision-making, planning, development and delivery of stroke services should be supported. Stroke services should work, where possible, with Maori and Pacific providers.

·         Community services should be equally accessible for stroke patients under 65 years as those 65 years and over. Community services for stroke patients under 65 years should be responsive to the needs of Maori and Pacific peoples.

·         Health practitioners and others providing stroke care should receive training and support in delivering culturally-competent, patient-centred care; including understanding the impact of culture on illness and rehabilitation.

Stroke recognition

·         The general public should receive ongoing education emphasising how to recognise the symptoms of stroke and the importance of early medical assistance.

·         The (face, arm, speech, time) message is appropriate for public awareness campaigns about both TIA and stroke.

·         The delivery of public awareness programmes should be tailored to specific target audiences, such as Maori and Pacific people.

For further recommendations, see the full report at www.stroke.org.nz

About stroke

·         A stroke is a sudden interruption of blood flow to the brain, causing brain cell damage. Basically, it is a brain attack.

·         Stroke is the third largest killer in New Zealand after cancer and heart disease.

·         Each year, about 6000 New Zealanders have a stroke, and about 2000 people die from stroke

·         Disabilities from stroke make it one of the highest consumers of hospital beds, services and community support in this country.

·         There are an estimated 45,000 stroke survivors in New Zealand, many of whom have disability and need significant daily support.

·         While there has been a significant fall in stroke incidence among the New Zealand European population between 1981–1982 and 2002–2003 there has been no fall in stroke incidence among Maori over the same period and stroke incidence among Pacific peoples appears to have increased.

·         The mean age of first stroke is 61 years in Maori and 65 years in Pacific people, compared with 76 years in the New Zealand European population.

ENDS

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