Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, June 27, 2017

Stroke care improving: study - Ontario

Meaningless puffery. It says only one thing about results - 30-day deaths. Fucking lazy bastards. They should be keel hauled for doing almost nothing.
http://www.intelligencer.ca/2017/06/26/stroke-care-improving-study
The Quinte region and southeastern Ontario are showing significant improvement in the treatment of stroke patients, a new report shows.

The report was released this month by the Institute for Clinical Evaluative Sciences (ICES) and the Ontario Stroke Network. It showed improvements to provincial stroke care in general while also emphasizing a need for more work.
The report found the Belleville area – with regional stroke care based at Belleville General Hospital – made the greatest improvement of any Ontario community.
The South East Local Health Integration Network (LHIN) had Ontario’s biggest improvement in 30-day mortality rate following an acute stroke. That rate dropped to 11.6 per cent in 2015-2016 from 14.2 per cent in the previous three years, the report noted, calling the decrease “unprecedented.”
That decrease can be measured in lives, said Dr. Andrew Samis.
“It’s between 25 and 30 less people dying in our region,” said Samis, an intensive care doctor with Quinte Health Care and the corporation’s “physician stroke champion.” He was instrumental in QHC’s 2014 implementation of its new stroke protocol.
Samis said there has been an “amazing” improvement in local care in recent years.
But he also said those improvements are “all for naught if someone chooses not to call 911.”
Samis said it’s essential anyone noticing the signs of a stroke call 911 immediately before doing anything else. That call, he explained, allows the stroke team crucial minutes to prepare. And in stroke care, minutes count.
That preparation means “your chance of dying goes down.”
The Heart and Stroke Foundation uses the acronym FAST to teach the signs of stroke:
• Face: Is it drooping?
• Arms: Can you raise both?
• Speech: Is it slurred or jumbled?
• Time to call 911 right away.
Access to care in an acute stroke unit in the South East LHIN was found to be 72.6 per cent and climbing. It was second only to the 80.6 per cent in the Waterloo Wellington LHIN.
“The results of this report highlight the great work being done throughout our region,” South East LHIN chief executive officer Paul Huras said in a press release.
“The rural nature of the South East region has often played a role in how patients access specialized stroke care,” Dr. Albert Jin, a Kingston stroke neurologist and medical director for the Regional Stroke Network of Southeastern Ontario, said in the release.
“By creating specialized stroke units in Belleville, Brockville and Kingston we have been able to ensure that patients across the region can quickly access teams of stroke experts,” he said. “This has played a significant role in improving the mortality rate across our LHIN.”
The region was also one of two top performers in providing home-based community rehabilitation, and hospital readmission rates for stroke survivors have been declining steadily. The region was third with a readmission rate of 6.7 per cent. The Ontario average was 7.1 per cent.
There were also improvements in other categories, including emergency department referrals to stroke prevention clinics.
Provincially, the report found the proportion of stroke patients treated in stroke units increased by nearly 11 per cent in 2015-2016.
The time from acute stroke to admission into inpatient rehabilitation dropped by one day from a median of nine days one year ago, the report found.
Yet 57 per cent of Ontario patients did not have access to stroke unit care and the average of inpatient rehabilitation therapy was 63 minutes per day compared to the target of 180 minutes.
“It is exciting and encouraging to see ongoing improvements in stroke care across Ontario,” said Linda Kelloway, the Ontario Stroke Network’s director of best practices, in a joint release with ICES. “More patients are getting to stroke units and wait time for admission to inpatient rehabilitation has decreased.
“However, we need to continue to move the bar up so that improvements continue and Ontarians will benefit.”
lhendry@postmedia.com


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