Platform Presentation The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

StrokeLink Program: A Success in Championing Stroke Care in Queensland (#5)

Andrew Wong 1 2 , Dominique A. Cadilhac 3 4 , Kelvin Hill 5 , Melita Stirling 5 , Lisa Yates 5 , Elizabeth Nutting 4 5 , Andrea Sanders 5 , Anne Hooper 6 , Linda Edwards 6 , Samantha Daly 6 , Julie Morrison 4 , Nicola Hall 6 , Lachlan L. Dalli 3 , Darshan Shah 6 , Lisa Murphy 5 , Rohan Grimley 3 7 8 , Monique F. Kilkenny 3 4
  1. Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
  2. University of Queensland, Brisbane, Queensland, Australia
  3. Monash University, Clayton, VICTORIA, Australia
  4. Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
  5. Stroke Foundation, Milton, Queensland, Australia
  6. Queensland Stroke Clinical Network, Queensland Health, Brisbane, Queensland, Australia
  7. Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  8. Griffith University, Birtinya, Queensland, Australia

Background: Established in 2008, StrokeLink is a collaboration including the Stroke Foundation and Queensland Stroke Clinical Network. StrokeLink involves workshops with hospital staff to review their clinical data and develop action plans to support the delivery of quality stroke care. The aim was to assess adherence to processes of care (PoC) for patients with stroke or transient ischaemic attack during the 3-year StrokeLink program, by receipt of a StrokeLink Workshop.

Methods: Time series analysis in Queensland hospitals across three time-points: T0 (July 2019 to June 2020); T1 (July 2020 to June 2021); T2 (July 2021 to June 2022). Outcomes included changes in individual PoC collected in the Australian Stroke Clinical Registry. Multivariable regression models, with adjustment for patient clustering, were used to compare adherence over time-points.

Results: Overall, 8/21 hospitals received a StrokeLink Workshop in T1/T2. Among patients treated in each time-point (n=6677 [T0]; n=7002 [T1]; n=6422 [T2]), characteristics were similar (43-45% female, median age 74 years). There was a 14% improvement in the odds of patients receiving stroke unit care in 2021-2022 vs 2019-2020. This improvement was greater among hospitals that received a StrokeLink Workshop (OR: 1.21; 95% CI: 1.06-1.39). There was an 8% improvement in the odds of patients receiving swallowing screens or assessments before oral intake in 2021-2022 vs 2019-2020. This improvement was greater among hospitals that received a StrokeLink Workshop (OR: 1.30; 95% CI: 1.16-1.46). There was a 27% improvement in the odds of patients being discharged from hospital with lipid-lowering medications in 2021-2022 vs 2019-2020. This improvement was greater among hospitals that received a StrokeLink Workshop (OR: 1.38; 95% CI: 1.16-1.64).

Conclusions: The StrokeLink Program, that uses externally facilitated workshops and registry data, continues to achieve clinical practice improvements in Queensland hospitals. Further investment and upscale of similar interventions in other Australian states is warranted.