System Change in Healthcare: The Ontario Stroke Strategy

Black, Diane; Lewis, Mary; Monaghan, Barry; Trypuc, Joann

doi:10.12927/hcq..16610

Cited by 9 publications

(11 citation statements)

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“…Since then, the Foundation has continued to be involved in the ongoing development of the OSS in partnership with the Ministry. The ongoing involvement of the Foundation is an enabler for ongoing success (Black et al 2003):…”

Section: Enablers For Successmentioning

confidence: 99%

“…1 In addition to the toll on a person and his or her family and friends, it is estimated that stroke costs the Canadian economy $2.7 billion a year. 2 Stroke has been described as Canada's most "forgotten disease," a hopeless condition where little can be done to prevent and mitigate its potentially life-altering effects (Black et al 2003). Less than 10 years ago, this perception was prevalent in Ontario not only with the public but within healthcare, research and government circles.…”

Section: Introductionmentioning

confidence: 99%

“…Less than 10 years ago, this perception was prevalent in Ontario not only with the public but within healthcare, research and government circles. In 1997, the Heart and Stroke Foundation of Ontario (Foundation) took on the challenge of changing the way stroke was viewed and treated in the province (Black et al 2003). The Foundation championed a successful three-year demonstration project to develop and test a regional model of coordinated care in four pilot sites in Ontario.…”

Section: Introductionmentioning

confidence: 99%

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Has Ontario's Stroke System Really Made a Difference?

Lewis

Trypuc²,

Lindsay³

et al. 2006

hcq

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Section: Enablers For Successmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Has Ontario's Stroke System Really Made a Difference?

Lewis

Trypuc²,

Lindsay³

et al. 2006

hcq

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“…SPCs were developed to facilitate early assessment, diagnosis, and treatment of patients with recent transient ischemic attack or nondisabling stroke. 11 We undertook a study to evaluate the effect of stroke prevention clinic referral on mortality and readmissions after an initial stroke admission.…”

mentioning

confidence: 99%

Organized Outpatient Care

Webster

Saposnik

Kapral

et al. 2011

Stroke

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Background and Purpose-Organized inpatient stroke care decreases mortality and morbidity irrespective of patient age, stroke severity, or stroke subtype. Limited information is available on whether organized outpatient care models such as stroke prevention clinics (SPC) improve outcomes after a transient ischemic attack or ischemic stroke. We compared 1-year mortality and stroke readmission in patients with transient ischemic attack or ischemic stroke referred versus not referred to an SPC. Methods-This was a retrospective cohort study including 16 468 consecutive patients with ischemic stroke or transient ischemic attack who were seen in the emergency department or admitted to a hospital between July 1, 2003 and March 31, 2008 at registry stroke centers (nϭ12) in the province of Ontario. Cox proportional hazards models and propensity score-matched analyses were used to evaluate 1-year mortality and readmission. Results-One-year mortality rates were lower in those referred to SPCs compared with those not referred, even after adjustment for age, sex, ethnic origin, income, comorbid conditions, stroke symptoms and severity, receipt of thrombolysis, stroke unit care, discharge destination, and functional status at discharge (adjusted hazard ratio [HR], 0.67; 95% CI, 0.60 -0.75). Survival analysis after propensity matching showed a 26% reduction in 1-year mortality (HR, 0.74; 95% CI, 0.65-0.84). There were no significant differences in 1-year readmission rates in those referred versus not referred to SPCs. Conclusions-Referral to an SPC is associated with a one-quarter reduction in mortality after ischemic stroke or transient ischemic attack. This supports the argument that outpatient stroke units may prove as effective as their inpatient counterparts. (Stroke. 2011;42:3176-3182.)

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“…In the UK, we examined both the general "umbrella" healthcare strategies that informed and influenced the reorganizing of stroke care services as well as the various reviews and policy guidelines that were generated after the launch of the National Stroke Strategy. In Canada, we looked at the two levels of policy development, the federal Canadian Stroke Strategy and various strategic provincial initiatives, focusing on the Ontario Stroke System, which has been acknowledged as an exemplar of successful implementation (Black et al 2003). We examined what stroke care knowledge was thought to be critical and how this knowledge and best practice was diffused.…”

Section: Introductionmentioning

confidence: 99%

Policy-Making as a Struggle for Meaning: Disentangling Knowledge Translation Across International Health Contexts

Oborn¹,

Komporozos-Athanasiou

Barrett³

et al. 2010

SSRN Journal

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The School of Management Working Paper Series is published to circulate the results of on-going research to a wider audience and to facilitate intellectual exchange and debate. The papers have been through a refereeing process and will subsequently be published in a revised form. Requested for permission to reproduce any article or part of Working paper should be sent to the publisher of this series. The School also has around 60 research students attached to the various research groups. A strong theme of research in the School is its international and comparative focus.Copyright © Komporozos-Athanasiou, A., Oborn, E., Barrettm M. and Chan, Y. 978-1-905846-46-7 Published by: Abstract: Over the last decade, research in medical science has focused on knowledge translation and diffusion of best practices to enable improved health outcomes. However, there has been less attention given to the role of policy development in influencing the translation of best practice across different national contexts. This paper argues that the underlying set of public discourses and ideological presuppositions of healthcare policy significantly influence its development with implications for the dissemination of best practices. Our research examines the policy discourses surrounding the treatment of stroke across Canada and UK, and how they are constituted by different underlying meanings of innovative best practice, user participation, and service restructuring. These findings provide an important yet overlooked starting point for understanding the role of policy development in knowledge transfer and the translation of science into health practice. ISBN:

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System Change in Healthcare: The Ontario Stroke Strategy

Cited by 9 publications

References 0 publications

Has Ontario's Stroke System Really Made a Difference?

Has Ontario's Stroke System Really Made a Difference?

Organized Outpatient Care

Policy-Making as a Struggle for Meaning: Disentangling Knowledge Translation Across International Health Contexts

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