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National Guideline Implementation: A Regional Approach To Stroke Thrombolysis Irene McGonnigle

National Guideline Implementation: A Regional Approach To Stroke Thrombolysis Irene McGonnigle South East Regional Planning. It will develop models of care likely to deliver better patient outcomes It will result in quicker or more equitable access to services across a region

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National Guideline Implementation: A Regional Approach To Stroke Thrombolysis Irene McGonnigle

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  1. National Guideline Implementation: A Regional Approach To Stroke Thrombolysis Irene McGonnigle South East Regional Planning

  2. It will develop models of care likely to deliver better patient outcomes It will result in quicker or more equitable access to services across a region It will enable a more effective utilisation of the clinical workforce It will enhance clinical and/or financial sustainability It will allow interdependent services to be developed more coherently It will facilitate service redesign and improvement It will deliver best value National Framework for Service Change in Scotland (2005) Why Regionally?

  3. - SIGN 108 (2008) – Thrombolysis ≤ 4.5 hours - Better Heart Disease and Stroke Action Plan (2009) - ClinicalStandards (2009) - National Audit Report (2009) National Stroke Publications

  4. SAS to bring the patient to the closest hospital providing thrombolysis Appropriately skilled staff in A+E for rapid assessment and triage Immediate CT scanning available A Specialist Consultant available for patient assessment, CT scan interpretation, diagnosis and decision to thrombolyse Availability of high dependency care –treat and monitor Dedicated stroke unit/ stroke beds REQUIREMENTSTo deliver stroke thrombolysis ≤ 4.5 hours24/7

  5. YES SAS to bring the patient to the closest hospital providing thrombolysis – Local training and protocols YES Appropriately skilled staff in A+E for rapid assessment and triage - Local training and protocols YES Immediate CT scanning available – Local training and service redesign NO A Specialist Consultant available for patient assessment, CT scan interpretation, diagnosis and decision to thrombolyse 24/7 YES Availability of high dependency care –treat and monitor - Local service redesign YES Dedicated stroke unit/ stroke beds - Local service redesign Achievable?

  6. ACCESS TO STROKE SPECIALISTS 24/7 By utilising Scottish Centre for Telehealth’s National Telestroke Network – video links Intra and Inter Board links and rotas ? Inter Regional Rotas AND PACs Problem SolvingRegionally

  7. Hub and Spoke Model Inter Regional PACs Inter Regional?

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