Abstract
Background and Purpose: To promote improvement of the quality of stroke care, the stroke team at Sunagawa City Medical Center (SCMC) provides various services. Methods: The stroke team consists of neurosurgeons, a neurologist, experienced nurses, physiotherapists, a speech therapist and case workers. The team organizes educational seminars at primary care facilities without neurological specialists. To increase the number of attendees, the team visits hospitals and educates whole institutes. To standardize the care, the stroke team has developed a common critical path for the treatment of acute and subacute stroke that can be easily and safely utilized at every institute and allows collaboration among hospitals. Our field of activity ranges within 30 km from SCMC. The subjects of our activities comprise all staff members working at each hospital located in this field from which possible candidates for rt-PA treatment will be referred to the stroke unit at SCMC. Our educational program follows Japanese guidelines for the management of stroke (2004). In this program, we educate on how to use anti-platelet and anti-coagulation drugs, the care of dementia, and clinical indicators that contribute to a better outcome and decreased mortality at the stroke unit, including the prevention and care of disturbed swallowing, the importance of early planning and initiation of rehabilitation programs. Results: The common critical path was found to contribute to the early transfer of acute stroke patients to the non-specialized institutes and the prevention of recurrence. Conclusion: On site educational seminars by the stroke team facilitated collaboration among regional institutes and improved the quality of stroke care.
