Stroke Standards of Care

The Stroke Standards of Care Across the Continuum (Central East Stroke Network Edition) document incorporates key stroke best practices from Canadian Stroke Best Practice Recommendations and Quality-Based Procedures: Clinical Handbook for Stroke and highlights how these practices have been implemented, providing a platform for regional continuous quality improvement.

Organizations in Central East Stroke Network (CESN) are requested to:

  1. identify an organizational site lead to support implementation
  2. complete the self-assessment for each site through collaboration of the organizational site lead and organizational interprofessional teams. The self-assessment may be completed electronically within the Word document, or by printing the document and completing manually. Organizations with an integrated stroke unit should complete both acute and inpatient rehabilitation standards. Organizations can add comments for items on a separate Word document.
  3. email to cesn@rvh.on.ca the completed self-assessment to CESN by December 2nd, 2019. The document may be forwarded as a scanned document, Word document, or PDF document. CESN will then review, compile results, and provide a summary of results and recommendations back to the organizations.
  4. initiate and implement quality improvement plans for standards not yet fully completed
  5. collaborate with the CESN to ensure that results are incorporated into regional stroke planning.

Click on the accordians below:

  • Stroke Standards of Care – contains the complete document including introduction, checklists and appendices (including Indicator Definitions)
  • Supporting Resources by Continuum – includes continuum specific checklists


Stroke Standards of Care Document
Hyperacute - Supporting Resources

1.0 System of Access for Stroke Care: Collaboration and coordination across and within regions, organization, and EMS should occur to get the right patient, to the right place, at the right time.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

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INDICATORS - SUPPORTING RESOURCES

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2.0 Early Assessment & Management: Rapid access to hyperacute assessment and intervention for TIA, minor stroke (non-disabling) and suspected acute stroke to achieve best patient outcomes, based on the Canadian Stroke Best Practice Recommendations.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

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INDICATORS - SUPPORTING RESOURCES

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3.0 Tissue Plasminogen Activator (tPA) & Endovascular Thrombectomy (EVT) Access: Provincial agreements and guidelines along with Telemedicine services should be employed to facilitate rapid access to tPA and EVT.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

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INDICATORS - SUPPORTING RESOURCES

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4.0 Specialized Teams & Resources: Access to stroke experts, diagnostic equipment and expertise, and a range of emergent and timely evidence-based treatment options.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATION & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

INFRASTRUCTURE & GOVERNANCE - SUPPORTING RESOURCES

Acute - Supporting Resources

1.0 System of Access for Stroke Care: Collaboration and coordination between and within hospitals to facilitate stroke unit care to get the right patient, to the right place, at the right time.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

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INDICATORS - SUPPORTING RESOURCES

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2.0 Early Assessment & Management: Timely access to acute assessment, management, prevention of secondary complications, and secondary prevention for TIA, minor stroke (non-disabling) and suspected acute stroke, to achieve best patient outcome, based on the Canadian Stroke Best Practice Recommendations.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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3.0 Community Reintegration Supports: Access to services that facilitate the successful resumption of life roles and activities.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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4.0 Specialized Teams & Resources: Access to stroke experts, resources, diagnostic equipment and expertise, and a range of timely and evidence-based treatment options.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

GOVERNANCE - SUPPORTING RESOURCES

Inpatient Rehabilitation - Supporting Resources

1.0 System of Access for Stroke Care: Collaboration and coordination between and within organizations and services to facilitate timely access to *inpatient (Inpt) stroke unit care to get the right patient, to the right place, at the right time. *Stroke unit must meet the Ontario definition.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

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INDICATORS - SUPPORTING RESOURCES

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2.0 Early Assessment & Management: Timely access to Inpt rehab assessment, management, prevention of secondary complications, and secondary prevention to achieve best patient outcomes, based on the Canadian Stroke Best Practice Recommendations

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES


3.0 Community Reintegration Supports: Access to services that facilitate the successful resumption of life roles and activities.  

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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4.0 Specialized Teams & Resources: Access to stroke experts, resources and equipment.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

GOVERNANCE - SUPPORTING RESOURCES

Outpatient Rehabilitation - Supporting Resources

1.0 System of Access for Stroke Care: Collaboration and coordination between and within organizations and services to facilitate timely access to outpatient (Outpt) rehabilitation and/or early supported discharge (ESD) services to get the right patient, to the right place, at the right time.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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2.0 Early Assessment & Management Timely access to Outpt rehab/ESD assessment, management, secondary prevention of complications and secondary prevention to achieve best patient outcomes, based on the Canadian Stroke Best Practice Recommendations

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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3.0 Community Reintegration Supports: Access to services that facilitate successful resumption of life roles and activities.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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4.0 Specialized Teams & Resources: Access to stroke experts, resources, equipment, and timely evidence-based treatment options.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

GOVERNANCE - SUPPORTING RESOURCES

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Community - Supporting Resources

1.0 System of Access for Stroke Care: Collaboration and coordination across service providers to facilitate access to primary care, rehabilitation and community supports to get the right patient, to the right place, at the right time.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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2.0 Early Assessment & Management: Timely access to community-based assessment, management, prevention of secondary complications, and secondary prevention for TIA, minor stroke (non-disabling) and suspected acute stroke, to achieve best patient outcomes, based on the Canadian Stroke Best Practice Recommendations.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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3.0 Community Reintegration Supports:  Access to services that facilitate the successful resumption of life roles and activities.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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4.0 Specialized Teams & Resources: Access to stroke experts, resources, diagnostic equipment and expertise, and a range of timely and evidence-based treatment options.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

GOVERNANCE - SUPPORTING RESOURCES

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Secondary Stroke Prevention - Supporting Resources

1.0 System of Access for Stroke Care: Coordinated and timely provision of secondary prevention services who have had an initial stroke or TIA to reduce the risk of recurrent events.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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2.0 Early Assessment & Management: Timely access to assessment and management for TIA, minor stroke (non-disabling) and suspected acute stroke, to achieve best client outcomes, based on the Canadian Stroke Best Practice Recommendations.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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3.0 Community Reintegration Supports: Access to services that facilitate the successful resumption of life roles and activities.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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4.0 Specialized Teams & Resources: Access to stroke experts, resources and a range of emergent and timely evidence-based treatment options.

PROTOCOLS & PROCESSES - SUPPORTING RESOURCES

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COMMUNICATIONS & TRANSITIONS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

INDICATORS - SUPPORTING RESOURCES

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