Abstracts Presented at the SMART STROKES 2016 Conference, 25–26 August 2016, Canberra, ACT

Introduction: Studies have shown significant benefit of an acute stroke team \n(AST) in improving thrombolysis rates, reducing door-to-CT, door-toneedle \nand in-hospital mortality, but this model is largely adapted by \nmetropolitan tertiary health care hospitals. The benefit of implementing \nacute stroke service in a primary care hospital is not known. \nAim: We undertook an internal audit to evaluate the effectiveness of AST \nin improving thrombolysis rates, door-to-CT, door-to-needle, length of \nstay (LOS) and mortality in a primary health care hospital. \nMethods: Data from 6 months pre and post commencement of AST and \nstroke unit was collected retrospectively. \nResults: We identified 152 and 160 patients pre and post commencement \nof services respectively. There was a 3 fold increase in the number of \nstroke calls and thrombolysis rates increased from 7.6% to 12.9%. A \nreduction of 44mins and 20mins was seen in door-to-CT and door-toneedle \ntimes respectively. The mean LOS reduced from 8 to 4 days while \nin-hospital mortality dropped from 12.5% to 6.25%. Failure rate of admission \nswallow screening improved from 51% to 5%. Cost-benefit analysis \nshowed $600 saving per patient. \nConclusions: Our study highlights the advantage of an AST in improving \nthrombolysis rates, time to treatment, and swallow screening. It reduces \nLOS and in-hospital mortality and results in an annual saving of has a \n$96,000. We plan to expand our service after hours and perform a larger \nprospective study to confirm our findings with the long-term aim of \nproviding service to a wider catchment area.