Population Served:
Windsor and Essex County with tertiary support to Chatham-Kent and Sarnia-Lambton
Programs and Services:
As the designated District Stroke Centre for this region, HDGH is changing the way we look at the delivery of care for stroke patients. The District Stroke Centre team and its partners work collaboratively with many local organizations and disciplines to plan and implement strategies for improving stroke care in response to local, regional and provincial identified needs and priorities.
Stroke is a devastating disease, a leading cause of morbidity and mortality, and one of the most expensive diseases to treat. There are more than 88,000 persons living with stroke in Ontario. Because of the vital services offered at HDGH, and its central location, services for stroke and TIA patients are coordinated through the hospital, improving cost efficiencies and delivering better care to patients in Windsor-Essex, Chatham-Kent, and Sarnia-Lambton. Further, the DSC has staff members working at each hospital in Windsor Essex to support best practice stroke care.
HDGH has five neurologists on staff directing expert care for area stroke patients; Dr. Michael Winger is the physician lead and Medical Director for the DSC. The dedicated and expert multidisciplinary stroke-care team has strongly supported consistent, evidence-based care for our stroke patients. This has resulted in enhanced clinical practices, new treatments, increased awareness, improved prevention and rehabilitation programs, and better education - all of which are having a positive impact on stroke outcomes here. So successful is the stroke pathway at HDGH that other health centres from as far away as Australia are looking at our program as a model.
The DSC also works to improve access to vascular disease prevention and intervention for urgent cases. As part of the Ontario Stroke System, the DSC is linked to regional and other district stroke centres, researchers, specialists and educational resources. Regular contact with these groups enables consistency in knowledge, management, education, communication and practice in stroke care. Andrea Drummond, the District Stroke Centre Coordinator, and Dr. Winger tap into resources and personnel who are positioned to support local area efforts to implement stroke best practices. Through these connections the DSC can participate in and facilitate stroke research, and support local, regional and national research projects.
Research clearly indicates that prevention measures, stroke treatments and good health practices help prevent death, reduce disability, and save billions of dollars in healthcare costs. HDGH, in conjunction with Windsor Regional Hospital, Leamington District Memorial Hospital, and other community agencies, is committed to providing a comprehensive best practice program to help improve stroke outcomes, while providing a continuum of care, support and critical therapies for victims of stroke and their families.
Education
The DSC works with its partners to co-plan customized professional and public education. Since its start-up in 2003, the DSC has provided education to health care providers that includes:
- Acute and Rehabilitation management of stroke
- Tips and tools for everyday living
- Videocasts of stroke rounds from across the province of Ontario
- Triage and Management of TIA’s
- National Institute of Health Stroke Scale (NIHSS)
- Dysphagia Screening
- Functional Electrical Stimulation in Stroke Rehabilitation
- Interprofessional Collaboration
- Alcohol and Chronic Disease
- Chedoke McMaster Stroke Assessment
- Motivational Interviewing
- Best Practice Stroke Care in the Long Term Care Setting
- Mentoring opportunities
- Online learning
Health Promotion and Disease Prevention
- Promotes awareness of and screens for hypertension at a monthly BP Screening Clinic at Hôtel-Dieu-Grace Hospital
- Works with organizations to build consistency in health promotion
- Provides prevention guidelines and algorithms for management of risk factors
- Supports efforts to integrate the prevention and management of chronic diseases
- Offers an urgent TIA and Stroke Prevention Clinic at HDGH. Here, TIAs are confirmed with rapid access to diagnostics and timely interventions to prevent stroke. Clinic staff are also available to discuss courses of action with physicians who choose to manage TIAs independently. Milder acute stroke patients are also provided multi-disciplinary, case management education and support post-discharge through the Stroke Prevention Clinic
- The TIA Clinic expedites access for patients in need of carotid endarterectomy or stenting, and receives referrals for same from across the Erie St. Clair Local Health Integration Network. This has resulted in shorter wait times for patients requiring this treatment.
- 845 patients were referred to the TIA/Stroke Prevention Clinic in 2009, a number that has risen annually since 2003.
Emergency and Acute Care
- An acute stroke protocol facilitating stroke thrombolysis
- An Acute Stroke Clinical Pathway and Order Set supporting current best practice, multi-disciplinary stroke care
- A Neurology Unit providing high level multi-disciplinary expert acute stroke care
- On-site CT, MRI, interventional radiological, neurosurgical and vascular surgery services
- An Acute Stroke Resource Nurse at HDGH who provides case management, professional and patient education.
- A Stroke Resource Nurse at Leamington District Memorial Hospital who provides case management, professional and patient education for patients living within the Leamington area
Rehabilitation
- A Stroke Rehabilitation Nurse and Stroke Resource Nurse who provides case management , and professional and patient education for the stroke patients in the post-acute phase who have more complex needs
- Stroke Survivor and Caregiver support groups
- The DSC works with the regional stroke rehabilitation coordinator and local agencies to advance the quality and accessibility of rehabilitation care, provide education and educational resources based on best practices in stroke rehabilitation
Community Re-Integration and Long-term Care