Introduction:
In Australia, timely hyperacute stroke care and stroke unit access continues to fall behind other high-income countries. In December 2023, the 30/60/90 National Stroke Targets were released to encourage health services to achieve these goals by 2030. In partnership with Safer Care Victoria (SCV) and Institute for Healthcare Improvement (IHI) commenced the Enhancing Stroke Care Collaborative that would support teams to make progress towards 30/60/90 targets by December 2025.
Methods:
A change package, developed from insights following expert working groups with leading stroke clinicians across Victoria and recommendations from the National Stroke Targets Action Plan.
An adaptation collaborative model was used and implemented across 18 health services in Victoria and Ambulance Victoria. Multidisciplinary teams participated in three in-person learning sessions, regular coaching calls, bi-monthly group learning calls and action periods focused on testing and implementing ideas across the change package that focused on reducing door-to-treatment times.
Collaborative data was presented on a bespoke dashboard developed by the Australian Stroke Clinical Registry (AuSCR). Data was analysed pre versus during the intervention period to understand the impact of the Collaborative model on supporting improvements towards the National Stroke Targets.
Results:
In 6 months, the collaborative sites had a median reduction of 9-minute door-to-needle time and 19-minute door-to-puncture time, equating to approximately 1286 days of disability saved. 10% improvement in thrombolysis within 60 minutes arrival to hospital was also seen. Improvements included a 5-minute reduction in door to brain scan.
Conclusion:
A targeted collaborative model that enables cross-sector sharing and clinician-led quality improvement initiatives, can result in timely treatment to hyperacute stroke care across Victoria.
Relevance to clinical practice or patient experience:
Improvement in key hyperacute stroke care metrics requires a collaborative response from health services which can show improvement in care metrics through interdepartmental coordination and executive endorsement.