An audit of the impact of implementation of a stroke care pathway in an acute teaching hospital

Background In 2002, a survey of stroke management was conducted in our institution benchmarked against the UK National Stroke Audit 2002. The conclusion was that management of stroke patients lacked organised and specialised care. The introduction of a stroke care pathway was recommended.Aims This audit assessed the clinical impact of implementation of a stroke care pathway by the general medical teams in an acute teaching hospital.Methods A random sample of 48 131 patients were surveyed in 2002 compared to 55 consecutive patients admitted with stroke in 2005.Results Despite introduction of a stroke care pathway, marked deficits persisted in acute management including delays in brain imaging and aspirin administration, assessment of acute parameters and interdisciplinary care.Conclusions Optimal care of stroke patients cannot be achieved by introducing a stroke care pathway alone. We recommend the urgent establishment of a stroke unit with a specialist consultant-led multidisciplinary stroke team.