NSW Stroke Reperfusion Project (SRPP)
- To improve early access to thrombolysis for ischaemic stroke patients.
- To improve pre-hospital assessment by paramedics for identification of stroke through a validated standardised assessment tool.
- To improve in-hospital reception, assessment and management of stroke patients to achieve early access to safe reperfusion.
- To improve mechanisms across the whole patient journey to deliver effective rehabilitation.
There are multiple benefits involved in this project:
- To train paramedics in the application of the ‘FAST’ (Face, Arm, Speech and Time) stroke assessment tool, which is both internationally recognised and validated
- To define, locate and govern permanently operating stroke-unit hospitals that offer thrombolytic therapy
- To provide road-based transport for stroke patients to arrive at stroke-unit hospitals within 4.5 hours of symptom onset
- To maintain strong networks between facilities, so patients are returned appropriately for ongoing acute and rehabilitative care, close to their point of origin, rather than remaining in designated 24/7 Acute Thrombolytic Centres (ATC)
- To model demand for road-based transport of patients to hospitals with stroke units that do not offer 24/7 thrombolysis, if the patient has missed the 4.5 hour target
The NSW SRPP will train paramedics to recognise a stroke that is possibly amenable to thrombolytic therapy.
Thrombolysis should only be delivered in emergency departments, stroke care units or high acuity units with adequate expertise and infrastructure for monitoring, rapid assessment and investigation for acute stroke patients.*
Early detection by paramedics will allow for these patients to be transported to a hospital that offers a 24/7 stroke thrombolysis service.
Following early access to a Computed Tomography (CT) scan and a neurology review, the decision on appropriateness of thrombolytic therapy will be made, and other clinical management commenced.
This program includes governance and guidelines for the transfer of stroke patients to the appropriate clinical service beyond the acute phase of their care.
* Clinical Guidelines for Stroke Management 2012: National Stroke Foundation
The Stroke Reperfusion Project has been trialled in 20 Acute Thrombolytic Centres across 11 Local Health Districts, as well as at the Sydney Adventist Hospital.
|May 2010||Stroke Reperfusion Project Committee formed|
|September 2010||Partnerships commenced with NSW Local Health Districts (LHD), Ambulance Service NSW (ASNSW)|
|September 2012||Correspondence to Chief Executives of Local Health Districts (LHD) inviting the LHD to participate in the project|
|November 2012||The ACI Stroke Network, CPDI and ASNSW collaborated through site visits to support strategies at the sites. This initial support was enhanced by the development of a Community of Interest monthly teleconference to bring sites together to discuss and provide guidance in relation to problem solving.|
|21 January 2013||Go Live date for the program|
|April 2013||Commence evaluation of the program in terms of economic and patient outcomes|
As nominated within the program logic of the evaluation, individual sites who participated in Phase 1 on the evaluation have received their qualitative and quantitative data.
Feedback on the program has been received and will be included in development of the program logic of Phase 2 of the evaluation
Phase 2 of the evaluation will be undertaken June 2015 - June 2016.
ACI Authenticated Acute Thrombolytic Centres.
|Central Coast Local Health District||Gosford Hospital|
|Hunter New England Local Health District||Tamworth Rural Referral Hospital|
John Hunter Hospital
|Illawarra Shoalhaven Local Health District||Wollongong Hospital|
|Mid North Coast Local Health District||Port Macquarie Base Hospital|
|Murrumbidgee Local Health District||Wagga Wagga Base Hospital|
|Nepean Blue Mountains Local Health District||Nepean Hospital|
|Northern NSW Local Health District||Lismore Base Hospital|
|Northern Sydney Local Health District||Royal North Shore Hospital|
Hornsby Ku-ring-gai Hospital
|South Eastern Sydney Local Health District||Prince of Wales Hospital|
St George Hospital
|South Western Sydney Local Health District||Campbelltown Hospital|
Bankstown Lidcombe Hospital
|St Vincent's Health Network||St Vincent's Health Network|
|Sydney Local Health District||Concord Repatriation General Hospital|
Royal Prince Alfred Hospital
|Western NSW Local Health District||Orange Health Service|
Bathurst Base Hospital
|Western Sydney Local Health District||Westmead Hospital|
Blacktown Mount Druitt Hospital (Blacktown Campus)
Key Date (location) Pilot Site Implementation Site
Phase 2 of the evaluation will be undertaken June 2015 - June 2016 and reflect patient and economic outcomes.
For further information: http://www.aci.health.nsw.gov.au/networks/stroke/priorities/stroke-reperfusion
National Stroke Foundation: http://strokefoundation.com.au/
Stroke Recovery Association NSW: http://www.strokensw.org.au
Network Manager - Stroke
02 9464 4614
Director, Acute Care
02 9464 4602
Page Top | Added: 8 November 2013 | Last modified: 25 June 2015