SCS researcher recognised by the American Stroke Association

A/Prof Cadilhac

Novel research evaluating rural stroke services has earned School of Clinical Sciences’ (SCS) Associate Professor Dominique Cadilhac 1^st prize in the prestigious 2014 Stroke Progress and Innovation Award.

The highly competitive prize is awarded to research that presents a new approach, new methodology, new interpretation of existing data, or new data with far-reaching implications. 

Associate Professor Cadilhac’s award winning paper, “Evaluation of Rural Stroke Services: Does Implementation of Coordinators and Pathways Improve Care in Rural Hospitals?” examined the quality of care for stroke patients in rural hospitals.

“Stroke is a leading cause of death and major cause of disability,” said Associate Professor Cadilhac.  “Inconsistent access to evidence-based interventions, such as stroke units (SUs) has been shown to have detrimental effects on patient outcomes.”

Importantly, geographic location also influences patient outcomes, with greater levels of death or dependency for stroke patients in rural communities.

Associate Professor Cadilhac’s team measured the effectiveness of the NSW government funded Rural Stroke Project (RSP), an organised stroke care intervention based on employment of a clinical coordinator to facilitate improvements in the organisation and delivery of recommended stroke care.

“Clinical coordinators played a significant role establishing SUs, developing protocols and standardised care plans, providing education and formalising appropriate patient transfer pathways to create a hub and spoke system of care.”

The selected RSP rural referral hospitals in the study sought to establish a hub and spoke approach with surrounding district hospitals.

“Part of the business rationale for RSP, the hub and spoke model has already been successfully implemented in rural areas and third world countries to maximise available health resources,”  said Associate Professor Cadilhac.  “Similar approaches have also been integrated within comprehensive stroke centres in the US and UK where this has improved access to clot-busting treatment for strokes that are caused by a blockage of a brain artery (otherwise known as intravenous thrombolysis).”

The results of this collaborative Monash, Florey and NSW Stroke Services-led study provide evidence for a successful approach to improving stroke care in rural locations.

“Investment in stroke clinical coordinators together with increased clinician resources effectively improved patient outcomes, resulting in more patients being discharged home,” added Associate Professor Cadilhac.

Associate Professor Cadilhac’s findings are also relevant to countries that do not have universal access to SUs and show that investment in leadership roles is worthwhile.

Associate Professor Cadilhac is Head, Translational Public Health Division, Stroke and Ageing Research Centre (STARC) in the Department of Medicine at SCS. 

She will be awarded her prize at the 2015 International Stroke Conference of the American Heart Association in Nashville next month.