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

Bridging the urban and regional divide in access to stroke unit care: evaluation of patient and staff experience of tele-stroke unit care (#183)

Lauren G Arthurson 1 , Felix C Ng 2 3 , Philip MC Choi 3 4 5
  1. Echuca Regional Health, Echuca, VIC, Australia
  2. Department of Medicine, University of Melbourne (Royal Melbourne Hospital), Melbourne, Victoria, Australia
  3. Neurology, Austin Health, Melbourne, Victoria, Australia
  4. Neurology, Eastern Health, Melbourne, Victoria, Australia
  5. Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia

Background: Regional Australians have reduced access to Stroke Unit Care despite being more likely to experience stroke. Echuca Regional Health and Eastern Health piloted a telestroke unit model to address this disparity.

 

Aims: The aim of this study was to understand patients’ and regional stroke clinician experience of a tele-stroke unit model.

 

Methods: BUILDS (Bridging the urban and regional divide in stroke care) provided assessment of all stroke/TIA patients by a stroke physician via telehealth with support from a local stroke coordinator. Development of education modules and case review audits for quality assurance were also included.

Patient and clinician surveys were developed using a 7-point Likert scale. These surveys included identification of disadvantages and advantages of the service.

 

Results:

37 experience surveys (15 females, 22 males) were analysed (34 patient, 3 family). 49% (n=18) had not used telehealth prior to BUILDS. 89% (n=33) indicated that the consultation reduced worry. 92% agreed the consultation was an acceptable way to access stroke services in regional areas. Free text analysis revealed patients felt comforted through access to a stroke specialist and stroke coordinator without the need to travel. 

25 staff experience surveys (15 medical, 2 nursing, 8 allied health) were completed. 80% (n=20) had experience with telehealth. 80% (n=20) agreed BUILDS provided support in stroke care. 68% (n=17) of staff with previous experience in metropolitan stroke centres agree that BUILDS was comparable to inpatient metropolitan care. Free text analysis highlighted the following advantages: face to face communication (Zoom) with the stroke physician, timely access to specialist care, stroke education, improved care planning with diagnostic certainty and perceived improved workflow.

 

Conclusion: 

Survey results revealed the tele-stroke model was positively received by patients and the clinical team. This information supports improving access to stroke unit care in regional areas using telehealth.