HSFO Mid-morning Program

What is secondary prevention?

• The early detection of disease, either when it produces symptoms or even before symptoms are noticed.

• The goal is to prevent disease from progressing to a completed stroke or to prevent recurrent stroke.

History of SSPCs

• Four original pilot sites: South East, West Greater Toronto, Central West, South West (1997)

• Conceived as part of the Coordinated Stroke Strategy in Towards An Integrated Stroke Strategy For Ontario (June 2000)

• Tailored after the Stroke Prevention Clinic (LHSC) and cardiac MULTIFIT programs (USA)

• Part of a continuum of stroke care within district and regional stroke centres

• “Offer comprehensive, cost-efficient, organized and expert risk factor management … to high-risk patients”

• Hospital-based to facilitate rapid access to diagnostic testing

• Currently 24 SSPCs

Team SPIRIT

• Stroke Performance Indicators for Reporting, Improvement and Translation– Joint initiative of the Canadian Stroke Network

and the Heart and Stroke Foundation– Part of the Registry of the Canadian Stroke

Network– Coordinated by staff at the Institute for Clinical

and Evaluative Sciences (ICES)– PIs – Patrice Lindsay and Frank Silver

• Enables clinicians and administrators to easily access data on stroke care to guide planning, assess performance and promote efficiency.

• Web-based tool

• First SSPCs joined in fall 2006

• 15 of the 24 SSPCs in Ontario are currently participating

Team Stats

• 12 SSPCs reporting data from September 1, 2007 to August 31, 2008

• Initial visits: 5,645

• Event to referral lag time:– mean 11.8 days– median 2.0 days

SSPC Initial Appointment Wait Times

0

5

10

15

20

25

30

35

Emergent Urgent Semi-urgent Elective

Triage Level

Day

s

SSPC Volumes

0

500

1000

1500

2000

2500

Emergent Urgent Semi-urgent Elective

Patient type

# o

f p

atie

nts

Diagnosis at initial visit

2548, 45%

1246, 22%

1832, 33%

Stroke

Stroke relevant

Other

SSPC’s are not a fountain of youth!

Stroke Prevention: Our best defense is a good offense.

Thanks to

• Melissa Stamplecoski, Project Manager, Registry of the Canadian Stroke Network, Institute for Clinical Evaluative Sciences

• Annette Robertson, Project Manager, Registry of the Canadian Stroke Network, Institute for Clinical Evaluative Sciences

• Dr. Frank Silver, Registry of the Canadian Stroke Network, Institute for Clinical Evaluative Sciences

• Linda Kelloway, Central South Stroke Education and Research Coordinator, Hamilton Health Sciences