The HNHB LHIN has collaborated with health service providers to develop regional strategies to improve stroke care. Integrated stroke care allows persons who have experienced a stroke access to best practice care provided by an inter-professional team with expertise in stroke.
Individuals who have had a stroke and receive their acute and rehabilitative care needs in a designated stroke unit are more likely to be alive, independent and living at home one year post stroke regardless of age, gender or stroke severity1.
The HNHB LHIN has one designated regional stroke centre and two designated district stroke centres as follows:
The Regional and District stroke centres offer emergency stroke management, acute care and rehabilitative services within hospital as well as outpatient rehabilitation services and secondary stroke prevention clinic services.
For more information regarding stroke signs and symptoms and resources, please refer to the following websites:
In 2013, Brant Community Healthcare System (BCHS) and Norfolk General Hospital in collaboration with the Central South Regional Stroke Network (CSRSN) and the HNHB LHIN developed an integrated model for stroke care at BCHS. This includes an integrated stroke unit (ISU) and the development of a community stroke rehabilitation model (CSRM).
The integration of stroke services at BCHS has dramatically improved access to evidence-based stroke unit care, including acute and rehabilitative services. Stroke unit care has shown to reduce the likelihood of death and disability in men and women of any age regardless of stroke severity by as much as 30%1. Individuals treated in stroke units have fewer complications, earlier recognition of pneumonia and earlier mobilization1. Integrated stroke care in the LHIN aligns with the Ontario Stroke Network’s strategic priorities for fewer strokes and better outcomes.
As part of the CSRM, patients are provided with seamless transitions from acute and rehabilitative care to the community. Prior to discharge from hospital, each patient is referred to a community stroke care coordinator, who reviews their rehabilitation goals and coordinates their care accordingly. Individuals who live beyond 30 minutes of an outpatient therapy program and/or do not have the tolerance to travel are referred to an in home community stroke rehabilitation program. Individuals who live within 30 minutes and have the tolerance to travel are referred to an outpatient stroke rehabilitation program. Following 8-12 weeks of community-based rehabilitation in one of these specialized programs, patients are referred to other appropriate community services, such as aphasia supportive groups, recreational programs (e.g., YMCA) and adult day programs.
In January 2017, Niagara Health System (NHS), opened a second stroke unit at the St. Catharines site to provide equitable access to best practice stroke care.
In May 2017, stroke services were further integrated in the Niagara North West when West Lincoln Memorial Hospital (WLMH) was integrated with the Hamilton Health Sciences (HHS) and the Hotel Dieu Shaver (HDS) to provide access to best practice stroke care. Access to acute stroke unit care is provided at the Hamilton General Hospital (HGH) and rehabilitative care services are provided at the Regional Rehabilitation Centre (RCC) in Hamilton or at the Hotel Dieu Shaver (HDS) Rehabilitative Care Centre in St. Catharines based on the first available bed as well as the choice of the person and family.
In January 2018, stroke services were further integrated in Hamilton between Hamilton Health Sciences (HHS) and St. Joseph’s Healthcare Hamilton (SJHH). This model has facilitated access to best practice stroke unit care at Hamilton Health Sciences (HHS).
In October 2018, stroke services were further integrated in Haldimand Norfolk when Haldimand War Memorial Hospital (HWMH) was integrated with the Niagara Health System (NHS) and Hamilton Health Sciences (HHS) to provide access to best practice stoke unit care based on the first available bed.
- Click here for a report on the development of the CSRM.
- Click here for a report on the evaluation of the CSRM.
1. Stroke Unit Trialists’ Collaboration. Organized Inpatient (Stroke Unit) Care for Stroke. Cochrane Database of Systematic Reviews 2007, Issue 4