Setting up an acute stroke service.

International Journal of Stroke : Official Journal of the International Stroke Society
Ian RecklessAlastair Buchan

Abstract

The administration of intravenous thrombolytic therapy to appropriate patients and the provision of care in a dedicated stroke unit setting form the pillars of evidence-based acute stroke care. Yet, the availability of these interventions remains variable around the world. Many challenges exist for physicians attempting to set up an acute stroke service for the first time. Based upon their experience in three countries, the authors propose 12 key steps in setting up a successful acute stroke service: *identify the building blocks *understand local funding mechanisms *forge partnerships *engage senior managers *obtain training *be inclusive *adapt to local surroundings *maintain a clinical focus *be incremental *capitalise on the enthusiasm of others *lead from the front; and *provide feedback. The authors then examine some of the specific barriers that may be encountered and offer three historical examples of evidence-based interventions that were slow to be adopted. An acute stroke service is evidence-based and cost effective, yet the ability of patients to access such a service is variable, even in the developed world. By considering 12 common sense steps, physicians and managers can maximise their chances of setting up a sus...Continue Reading

References

Nov 1, 1967·American Journal of Public Health and the Nation's Health
Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
May 2, 1998·JAMA : the Journal of the American Medical Association·A M PancioliE Jauch
Aug 26, 1998·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·P E PepeD Floccare
Feb 5, 1999·Stroke; a Journal of Cerebral Circulation·S R Levine, M Gorman
Feb 20, 1999·QJM : Monthly Journal of the Association of Physicians·H R SalisburyD J Reynolds
Mar 27, 1999·Annals of Emergency Medicine·R U KothariJ Broderick
Mar 7, 2000·JAMA : the Journal of the American Medical Association·I L KatzanC A Sila
Oct 23, 2001·BMJ : British Medical Journal·J KennedyH J Barnett
Jul 11, 2002·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·B WilsonM Robinson
Mar 8, 2003·Stroke; a Journal of Cerebral Circulation·Irene L KatzanUNKNOWN Cleveland Clinic Health System Stroke Quality Improvement Team
Mar 29, 2003·Stroke; a Journal of Cerebral Circulation·Peter U HeuschmannUNKNOWN Competence Net Stroke
Aug 2, 1958·Journal of the American Medical Association·B J SUSSMAN, T S FITCH
Oct 31, 2003·Cerebrovascular Diseases·UNKNOWN European Stroke Initiative Executive CommitteePhilip Bath
Dec 20, 2003·Current Neurology and Neuroscience Reports·James KennedyAlastair M Buchan
Mar 16, 2004·Lancet·Werner HackeUNKNOWN NINDS rt-PA Study Group Investigators
Jan 11, 2005·Family Practice·Laura J MorganJoanne Jordan
Jan 22, 2005·Stroke; a Journal of Cerebral Circulation·Jeyaraj D PandianGeorge Abraham
May 10, 2005·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Martha A Q Curley
May 18, 2005·Journal of Neurology, Neurosurgery, and Psychiatry·N U Weir, A M Buchan
Sep 9, 2005·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Janet E BrayChristopher Bladin
Nov 2, 2005·Journal of the Royal Society of Medicine·U Tröhler
Mar 21, 2006·Lancet Neurology·Peter M RothwellS Claiborne Johnston
May 12, 2006·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·L De DominicisG Giuliani
Aug 17, 2006·Cerebrovascular Diseases·C WeimarUNKNOWN German Stroke Study Collaboration
Sep 30, 2006·Stroke; a Journal of Cerebral Circulation·Marjory MoodieUNKNOWN SCOPES Study Group
Nov 24, 2006·Stroke; a Journal of Cerebral Circulation·Lars EhlersMette Kjølby
Jan 6, 2007·Stroke; a Journal of Cerebral Circulation·Ian MosleyHelen Dewey
Jan 30, 2007·Lancet·Livia CandeliseUNKNOWN PROSIT Study Group
Feb 3, 2007·Cerebrovascular Diseases·Didier LeysUNKNOWN European Stroke Initiative Executive Committee
Apr 17, 2007·Cerebrovascular Diseases·Peter Langhorne
May 5, 2007·Annals of Emergency Medicine·H Christian SchumacherJohn Pile-Spellman
Aug 29, 2007·Neurology·S SchwabUNKNOWN TEMPiS Group
Sep 19, 2007·Environmental Science & Technology·Richard Owen, Richard Handy
Aug 19, 2008·International Journal of Stroke : Official Journal of the International Stroke Society·Jeyaraj Durai PandianJagaralpudi M K Murthy

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Citations

Apr 9, 2013·Archives of Physical Medicine and Rehabilitation·Natasha Kareem BruscoNora Shields
Dec 17, 2009·Current Opinion in Neurology·Patrik Michel

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