The whole world of stroke is condemned to less than mediocrity, INCOMPETENCE, and the poor outcomes are visited upon the stroke survivors, not the stroke medical world.
https://www.irishtimes.com/opinion/editorial/stroke-care-condemned-to-mediocrity-1.3203767
https://www.irishtimes.com/opinion/editorial/stroke-care-condemned-to-mediocrity-1.3203767
The warning from the head of the national stroke programme is stark: inertia and resistance to change within the Health Service Executive (HSE) is leaving the Republic unprepared to cope with a significant increase in the number of stroke patients.
In a formal review of the programme he has led since 2010, Professor Joseph Harbison
is strongly critical of resistance to change within the Health Service
Executive (HSE). In a telling insight into the modus operandi of the HSE
his review states that “with current HSE structures, implementing and
managing change is extremely challenging. Even when a plan is in place
and resources found, it is our experience it is a mistake to assume that
this will automatically happen without continued attention,
intervention and agitation.”
Almost 8,500 Irish people
experience a stroke each year. As well as the 800 who die from the
condition, many are left severely disabled as a result. The incidence of
stroke is set to rise by approximately 50 per cent in the next ten
years. Having access to a dedicated stroke unit has been shown to
significantly reduce disability and to improve long -term prognosis.
Stroke units are staffed by specialist teams of doctors, nurses and
allied health professionals. However six acute hospitals in the State
remain without such units.
We still lag behind other European countries when outcomes for stroke patients are measured
That it took three years to
appoint 40 staff is an example of the inertia that pervades the HSE, and
not just in the area of stroke care. There is a culture in the
organisation that rewards the status quo; attempting to bring about
change frequently exposes managers to retribution rather than
affirmation.
Innovation and imagination in the
absence of adequate resources has brought some improvement for stroke
patients in the last seven years. Mortality from stroke has been cut by a
quarter, while the number of patients discharged from hospital without a
rehabilitation programme put in place has dropped by almost 50 per
cent. But we still lag behind other European countries when outcomes for
stroke patients are measured.
Prof Harbison is right to speak
out. It is likely roadblocks to enhanced stroke care are replicated in
other clinical areas. Which begs the question: must we accept a health
service that is condemned to perpetual mediocrity?
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