New funding to expand stroke registry as audit data reveals concerning findings

Pharma News: A 3-year, $1.5 million funding boost from the government’s National Clinical Quality Registry Program will enable the Australian Stroke Clinical Registry (AuSCR) at The Florey to expand its vital work in improving stroke care across the nation.

A recent Stroke Foundation audit of 100 acute hospital services across Australia found that our nation is falling well below international standards and not meeting national benchmark treatment times that are set to ensure people receive the best treatment and reduce death and disability.

Among the key findings was that the median time from stroke onset to arrival in the emergency department is 4 hours and 24 minutes in 2023 which is 6 minutes longer than in 2021 and significantly longer than the 2019 pre-covid results of 3 hours and 36 minutes.

It also highlighted that almost three in every ten stroke patients who arrived in hospital were first admitted to a general medical ward rather than an acute stroke unit and access to stroke unit care has stagnated and is nowhere near the national target of 90%.

While most state governments already support the AuSCR program, this new funding will forge a sustainable partnership between all jurisdictions and the Commonwealth, targeting stroke – a critical national health priority.

Professor Dominique Cadilhac, the AuSCR data custodian, emphasised the importance of this expansion beyond the 65 hospitals it already monitors, noting that the registry’s impact on stroke care has already been profound.

“With the Commonwealth’s support, we will be able to achieve greater coverage across the country in hospitals admitting patients with stroke. Our work will extend to more locations including smaller hospitals to provide a comprehensive overview of stroke care in Australia, never previously achieved,” she said.

Stroke continues to be a major burden on Australia’s healthcare system, both in terms of disease impact and cost.

“Every 19 minutes, somebody experiences their first stroke, with those in regional areas 17 percent more likely to suffer a stroke than those in metropolitan areas. We know that smaller regional hospitals especially will benefit from our monitoring of their acute stroke care, and we look forward to working closely with them,” Professor Cadilhac explained.

She highlighted the critical role hospitals play in patient recovery, stating, “Whether a person recovers well from stroke or has a lengthy rehabilitation can depend on the hospital where they’re treated. We are working to change that by improving gathering and sharing of information related to stroke care.”

Additional results from the Stroke Foundation audit revealed that only 29% of patients received thrombolysis within 60 minutes of arrival in hospital (27% in 2021), and well below rates achieved in the UK and US (both above 60%). Reperfusion treatments (intravenous thrombolysis and/or endovascular thrombectomy), did not increase in Australia in 2023 with 4,815 receiving these therapies (vs 4,899 in 2021).

Recognising stroke as a high-priority clinical domain, the Australian Safety and Quality Commission in healthcare has underscored the need for robust monitoring. All hospitals currently collaborating with AuSCR support the National Stroke Targets, established in 2023 through a partnership with registry consortium members, including the Stroke Foundation and the Australian and New Zealand Stroke Organisation.

To align with international best practices, Professor Cadilhac stressed the necessity of giving all hospitals access to AuSCR’s data infrastructure to track their progress against these targets.

“We look forward to working with our existing and new partners to improve the quality of stroke care in Australia and reach the National Stroke Targets by 2030. We’re shining a light on areas that hospitals can target for improvement, as well as highlighting areas where states are leading the way and can help others,” she stated.

The Florey secured the additional funding on behalf of the stroke registry consortium, which includes the Stroke Foundation, the Australian and New Zealand Stroke Organisation, and Monash University.

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