Northwestern Ontario Regional Stroke Network

Medical Centre 201 – 984 Oliver Road, Thunder Bay, ON P7B 7C7

Phone: 807-684-6703 e-mail: nwostroke@tbh.net

www.nwostroke.ca

Leader and Effective Advisor

Indigenous Stroke Care

Supporting Best Practice

Implementing our Strategic Directions

Presentations at 2016 Canadian Stroke Congress in Quebec City:

Oral:

• Screening for Depression in an Acute Regional Stroke Unit

Poster:

NWORSN Initiatives:

• Implementation of a New Evidence-Based Triage Toolkit for Transient Ischemic Attack/Mild Non-Disabling Stroke in Northwestern Ontario

• Using Technology to Facilitate Peer Support for Stroke Survivors in Northwestern Ontario

Provincial Initiatives:

• Building a Stroke Unit Toolkit-A Phased-in Approach

• Stroke Prevention Model of Care Review

• Post Stroke Community Based Exercise Guidelines: Update 2015

• Interprofessional Stroke Core Competency Framework

Education was provided to 1756 health care professionals and public throughout NWO via face to face, OTN videoconference, live and archived webcast and webinar.

162 health care professionals attended webinars on the Canadian Stroke Best Practice Recommendations/Quality Based Procedures coordinated by NWORSN.

Hosted the prestigious Heart and Stroke Barnett Lectureship in collaboration with NOSM and the Heart & Stroke Foundation, broadcasted nationally for the first time. Dr. Adnan Qureshi, a leading stroke neurologist presented on Parameter Optimized Treatment for Acute Ischemic Stroke Patients.

Heart and Stroke Foundation and Goldcorp partnership supported travels to Dryden, Ear Falls and Red Lake to promote Stroke Best Practices with the Family Health Teams, NWEMS, Goldcorp Mine Nursing staff, Red Lake Hospital staff, LTC and community health care providers.

Provided stroke education to 236 2nd & 3rd year Lakehead University Nursing Students.

In collaboration with stakeholders developed and implemented protocols to ensure that NWO residents receive timely care in facilities that are capable of providing services for the diagnosis and hyperacute treatment of stroke.

• Northwestern Ontario Acute Stroke Bypass and Transfer Agreement supports direct transport protocols for Nipigon, Terrace Bay, Atikokan, Rainy River, Emo and Red Lake.

• Emergency Department Transportation and Management for Acute Stroke Algorithms developed to support urgent patient transfers for patients presenting with suspected acute stroke symptoms.

Research project involvement:

• Promoting Optimal Physical Exercise for Life

• ONDRI (Ontario Neurodegenerative Research Initiative)

• Prevalence of Carotid Artery Disease in NWO

• NAVIGATE ESUS (Embolic Stroke Undetermined Source)

• DOC Utility Study (Depression, Obstructive Sleep Apnea and Cognitive Impairment)

• Evaluation of TIA and Mild Non-Disabling Stoke TRIAGE Toolkit

Publication of the Ontario Stroke Report Card in June 2016 highlighted the NW LHIN as the Provincial high performer in the proportion of ischemic stroke patients receiving tPA in FY2014/15 at 14% (2% higher than provincial average).

Engagement with the 14 Family Health Teams in the NW LHIN on stroke care and current network initiatives throughout the region.

Members of NWORSN participated and completed work on the Provincial Integrated Workplan Committees:

• Stroke Unit Toolkit assists organizations in the development of new stroke units, or to improve existing units.

• Interprofessional Stroke Core Competency Framework provides health care professionals working in stroke with a clear, comprehensive way to achieve core competencies utilizing on-line learning.

Ongoing work continues in the following:

• Secondary Prevention Committee will identify and make recommendations on strategies to operationalize core elements of secondary stroke prevention, to enhance system-wide performance and outcomes.

• Outpatient and Community Rehabilitation Committee will support regions to be able to conduct a needs analysis, and will collect, create and share resources to assist delivery of care that aligns with Quality Based Procedures.

Launched redesigned Website June 2016 with numerous navigation presentations provided to health care professionals, patients and caregivers across the region.

Site visits to Fort Frances, Dryden and Kenora. Discussed the NW LHIN Stroke Report Card and engaged stroke care providers through education and learning opportunities.

Participated in Provincial Stroke Rounds Planning Committee. These CME Accredited events reached 886 participants through videoconference; 134 through OTN Live Webcast and 438 through OTN Archive Webcast.

In collaboration with the Nursing Practice Consultant, First Nations and Inuit Health Branch Health Canada, developed a Northwestern Ontario TIA and Mild Non-Disabling Stroke TRIAGE Algorithm for Remote Northern Communities. Education provided to 37 nurses and NP’s from 16 sites.

In collaboration with SJCG, submitted a response to the Assembly of First Nations-First Nations and Inuit Health Branch Joint Review Steering Committee for the Non-Insured Medical Supplies and Equipment policy review as well as a briefing note “Access to Rehabilitative Services in Northwestern Ontario” which was requested by the Chiefs of Ontario.

Representative on the provincial advisory group for Supporting Indigenous Culture in Long Term Care.

Provided an engagement learning day for two leads from Indigenous Culture in Long Term Care Advisory Group on local indigenous culture at TBRHSC and SJCG.

Presented at K.Net for the Elders Day via videoconferencing on Heart and Stroke Health and Lifestyles.

Engaged in the NW LHIN Aboriginal Health Forum and provided a NWORSN display booth.

Panel member in a Health Systems Workshop at the 2016 Canadian Stroke Congress in Quebec City on Identifying Health Needs and Challenges with Indigenous Populations.

Strategic Plan Achievements: A year in review

April 1, 2016 to March 31, 2017

VisionFewer strokes. Better outcomes.

MissionTo continuously improve stroke prevention, care, recovery and re-integration.

Visits to the Stroke Prevention Clinic at Thunder BayRegional Health Sciences Centre

Telestroke sites in Dryden, Fort Frances, Kenora, and Sioux Lookout activated the Ontario Telestroke Program

Inpatient Admissions for Stroke and TIA at the Regional Stroke Centre

Supportive Conversation for Aphasia Workshops were held in Kenora and Thunder Bay,

Outpatient and Community Rehabilitation programs are partnering to optimize

referral processes for people with stroke

Community engagement displays throughout the region

Interactions with people during Stroke Month 2016

Articles written on the www.nwostroke.ca

website by local stroke Health Care Professionals

targeting our region

Visits to the www.nwostroke.ca website since June 1st, 2016

Participants in Best Practice education in Long Term Care

Community Stroke Awareness

presentations

Stroke survivors and caregivers

connected with the region through a live and videoconference event in partnership with March of Dimes - Stroke Recovery Canada during Stoke MonthClinicians

were supported to participate in the Graduate Certificate

of Stroke Rehabilitation program through the University of Alberta

Clinicians from Regional Stroke Centre

and Telestroke sites renewed AlphaFIM credentials

Code Stroke education provided to

newly hired TBRHSC nurses

Stroke orientation provided to

TBRHSC-ED, ICU and RSU nurses

ISCHEMIC TIAHEMORRHAGIC people received training

EMS and first responders participated in training sessions

patients received tPA

times at the Regional Stroke Centre

Code Stroke was activated The Rehabilitation Intensity Project Team at SJCG inpatient rehabilitation unit is working towards the

Median time for patients to access endarterectomy

days, exceeding the target of 14 days

Median Door to

Needle Time at the Regional Stroke Centre was

minutes, 15 minutes faster than last year

Dr. Paul Dorian, leading cardiologist presented on Stroke Prevention and Atrial Fibrillation Management to

Over

visits to Community Stroke Prevention Clinics in Marathon, Fort Frances, Sioux Lookout and Kenora

videoconferencing which eliminated the need to travel for appointments

TBRHSC Stroke Prevention Clinic visits used

Prevention

Supporting Stroke Care across the Continuum

HyperacutePublic Awareness

Community & Long Term CareAcute Rehabilitation

1377 185 651

44

9160022

52

769

37

6600

297

75

315 7549

5367

150%

18258

143

31

2 3HOURS

Increase from previous year

health care professionals A 26% delivery rate

(provincial rate = 27%)

times resulting in the delivery of tPA to 15 patients.

per day target for therapy