A collaborative relationship between The Scarborough Hospital (TSH) and the Scarborough Stroke Clinic is resulting in better outcomes for patients with transient ischemic attacks (TIA) – often called “mini strokes.” The partnership ensures that TIA patients receive high quality, specialized care quickly and has reduced the number of TIA patients admitted to the hospital.
How it works: When TIA patients arrive at the TSH Emergency Department, they are first assessed and then referred to the Scarborough Stroke Clinic. This transfer of care enables patients to be seen by neurologists and a clinical nurse specialist, have diagnostic testing completed swiftly, and receive clinical assessment, treatment, care coordination, patient/family education, and rapid follow-up care.
“This partnership helps stroke and TIA patients get the care they need from neurologists and other medical specialists, without being admitted to the hospital, which is more convenient for patients and their families, and helps reduce the strain on hospital Emergency Departments and acute care units,” said Dr. Neal Parekh, TSH Neurologist, and Founder and Medical Director of the Scarborough Stroke Clinic.
Since the partnership began in 2013, TSH has seen a 63 per cent reduction in TIA admissions. For TIA patients who are admitted to the hospital, their acute length of stay at the TSH Stroke Unit has been reduced by 35 per cent. Upon discharge, patients are referred to the Scarborough Stroke Clinic for follow-up, which supports their continuity of care from hospital to home. Additionally, the number of TIA patients readmitted to the hospital within 30 days dropped by 84 per cent.
The hospital-clinic partnership is a prime example of TSH’s ongoing focus on integrated care networks as part of its 2015-2019 Strategic Plan. Integrated care networks, such as this, coordinate health care services so that patients get the care they need, when they need it, in the most appropriate setting.
“I had excellent care at the hospital and the Stroke clinic,” said David Baird, a previous TIA patient and Past Chair of TSH’s Board of Directors. “When I was discharged, the hospital doctors gave me a medication schedule chart, and at the stroke clinic, the staff helped me understand how to use it. Practical support like this, and the convenience of getting care at the Stroke Clinic, rather than the hospital, continues to be an invaluable part of my recovery.”
All TSH stroke patients are referred to the Scarborough Stroke Clinic eventually, and clinic volumes are steadily climbing, currently reaching more than 1,000 patients per year. When inpatients are discharged from the hospital, they are referred to the clinic to receive counselling and stroke education from a clinical nurse specialist, while a neurologist reviews their test results and medicine plan, and recommends follow-up care.
Along with providing specialized care for patients, the Scarborough Stroke Clinic is dedicated to education and research for physicians. Medical residents rotate through to study best practice in evidence-informed TIA and stroke care, and research conducted by the clinic has led to two presentations at Canadian Stroke Congress, a national stroke conference.