Stephanie Thompson1, Alan Barber2, John Fink3, John Gommans4, Alan Davis5, Matire Harwood6, Jeroen Douwes7, Dominique A Cadilhac8, Harry McNaughton9, Jackie Girvan10, Ginny Abernethy11, Valery Feigin12, Andrew Wilson13, Hayley Dennison14, Marine Corbin15, William Levack16, Annemarei Ranta17. 1. PhD Student, Department of Medicine, University of Otago, Wellington. 2. Professor of Neurology, University of Auckland, Auckland. 3. Neurologist, Canterbury District Health Board, Christchurch. 4. General Physician, Hawke's Bay District Health Board, Hastings. 5. Geriatrician, Northland District Health Board, Whangarei. 6. General Practitioner, University of Auckland, Auckland. 7. Professor of Public Health, Director, Centre for Public Health Research, Massey University, Wellington. 8. Professor of Public Health, Monash University, Clayton, Victoria, Australia. 9. Neurologist, Medical Research Institute of New Zealand, Wellington. 10. Consumer, Ashburton. 11. National Stroke Network Project Manager, Stroke Foundation of New Zealand, Wellington. 12. Professor of Neurology, Auckland University of Technology, Auckland. 13. Rural Health Physician, Nelson-Marlborough District Health Board, Blenheim. 14. Research Fellow, Centre for Public Health Research, Massey University, Wellington. 15. Research Officer, Centre for Public Health Research, Massey University, Wellington. 16. Professor and Dean and Head of Wellington Campus, University of Otago, Wellington. 17. Associate Professor of Neurology and Head of Department, Department of Medicine, University of Otago, Wellington; Consultant Neurologist, Department of Neurology, Capital and Coast District Health Board, Wellington.
Abstract
AIM: To describe stroke services currently offered in New Zealand hospitals and compare service provision in urban and non-urban settings. METHOD: An online questionnaire was sent to stroke lead clinicians at all New Zealand District Health Boards (DHBs). Questions covered number and location of stroke inpatients, stroke service configuration, use of guidelines/protocols, staffing mix, access to staff education, and culture appropriate care. RESULTS: There were responses from all 20 DHBs. Differences between urban and non-urban hospitals included: access to acute stroke units (55.6% non-urban vs 100% urban; p=0.013), stroke clinical nurse specialists (50% vs 90%; p=0.034), stroke clot retrieval (38.9% vs 80%; p=0.037) and Pacific support services (55.6% vs 100%; p=0.030). There were also differences in carer training (66.7% non-urban vs 100% urban; p=0.039) and goal-specific rehabilitation plans in the community (61.1% vs 100%; p=0.023). Access to TIA services, stroke rehabilitation units, early supported discharge, psychologists, continuing staff education, and culturally responsive stroke care were suboptimal irrespective of hospital location. CONCLUSION: Hospital location is associated with differences in stroke services provision across New Zealand and ongoing work is required to optimise consistent access to best practice care. These results, in conjunction with an ongoing (REGIONS Care) study, will be used to determine whether this affects patient outcomes.
AIM: To describe stroke services currently offered in New Zealand hospitals and compare service provision in urban and non-urban settings. METHOD: An online questionnaire was sent to stroke lead clinicians at all New Zealand District Health Boards (DHBs). Questions covered number and location of stroke inpatients, stroke service configuration, use of guidelines/protocols, staffing mix, access to staff education, and culture appropriate care. RESULTS: There were responses from all 20 DHBs. Differences between urban and non-urban hospitals included: access to acute stroke units (55.6% non-urban vs 100% urban; p=0.013), stroke clinical nurse specialists (50% vs 90%; p=0.034), stroke clot retrieval (38.9% vs 80%; p=0.037) and Pacific support services (55.6% vs 100%; p=0.030). There were also differences in carer training (66.7% non-urban vs 100% urban; p=0.039) and goal-specific rehabilitation plans in the community (61.1% vs 100%; p=0.023). Access to TIA services, stroke rehabilitation units, early supported discharge, psychologists, continuing staff education, and culturally responsive stroke care were suboptimal irrespective of hospital location. CONCLUSION: Hospital location is associated with differences in stroke services provision across New Zealand and ongoing work is required to optimise consistent access to best practice care. These results, in conjunction with an ongoing (REGIONS Care) study, will be used to determine whether this affects patient outcomes.
Authors: Kristina M Kokorelias; Michelle L A Nelson; Jill I Cameron; Heather Colquhoun; Sarah Munce; Sander L Hitzig; Nancy M Salbach; Julia Martyniuk; Carolyn Steele Gray; Terence Tang; Rosalie H Wang; Patrice Lindsay; Mark Bayley; Navaldeep Kaur; Hardeep Singh Journal: BMJ Open Date: 2022-04-27 Impact factor: 3.006