Stroke care lags behind

There are significant gaps in the quality of stroke care, including a lack of access to stroke units and underuse of thrombolysis, a clinical audit has found. The National Stroke Foundation review of more than 3,000 patients found there has been little or no improvement in stroke care over the past two years, and in some cases the quality of treatment has actually declined since the last audit in 2007. The review found that only one in two patients are treated on a stroke unit and just three percent are being thrombolysed with tissue plasminogen activator (tPA). The review also found there have been no improvements in discharge planning processes for outpatients, although this was identified as a key area needing improvement in the 2007 audit. Assessments and interventions known to prevent complications were sometimes not provided to patients at all, and delays with time-dependant documentation sometimes led to problems receiving recommended care, it noted. The two-part audit also included an organisation survey - released in August - that found 22 additional specialised stroke care units are still needed across Australia to provide adequate services and resources. However, the audit did note improvements in preventative patient medications and the timeliness of assessment for speech pathology, occupational therapy and physiotherapy. “The treatment of stroke patients remains inadequate, with processes known to save lives from death and disability not used in enough cases,” said National Stroke Foundation CEO, Dr Erin Lalor. “There is an urgent need … to devote greater resources to stroke care to reduce the impact of Australia’s second biggest killer.” The full audit can be viewed at http://www.strokefoundation.com.au/...