‘Gold Plated’ Stroke Service at Hauora Tairāwhiti

3 November 2016

A recent initiative by Hauora Tairāwhiti to reduce secondary strokes has been called “a gold plated stroke service for Tairāwhiti patients,” by the Midlands Stroke Network.

The stroke review clinic is a unique concept within the Midlands Health Network. The service invites people who have had a stroke to a clinic at Gisborne Hospital, where they ‘speed date’ a number of specialists in one session, rather than attending multiple appointments.

A stroke is a brain attack; it is a sudden interruption of blood flow to part of the brain causing it to stop working. Strokes are the third largest killer in New Zealand (about 2,500 people every year), and the risk of having a secondary stroke is very high during the first 12 months of recovery. The stroke review clinic invites people recovering from a stroke to attend at 3, 6, 9 and 12 month intervals, at which time they are discharged from the service, or referred to continue treatment where necessary.

The service was spearheaded by Dr Intesar Malik in May 2015 and takes place once a month. Participants who have had a stroke are invited to Gisborne Hospital, where they visit with medical specialists including a consultant, nurse, occupational therapist, physio therapist and speech and language therapist. Dr Malik commented “we are offering a one-stop-shop for stroke care. The clinic offers a unique opportunity for the medical team working with a patient to discuss a case and develop a care plan that works for everyone. This approach minimizes the resource spent individually assessing a patient for each specialism, and ensures we are all on the same page, working together for the best interest of the patient.”

Stroke Clinic

One such patient is 80 year old Velma McLean who commented “When I was transferred to Gisborne Hospital after my stroke, the staff at Tauranga hospital assured me that I would be heading to a hospital highly competent in rehabilitation procedures. They were correct.” Velma has attended the clinic twice following her stroke in November 2015. She continued “In the beginning, they said that I may never walk again. The support of the nurses and my husband Barry means that I can now move around my home, and retain some independence. I meet with Therapists, Dr’s, Nurses and Physios at the clinic who monitor my progress and prescribe further exercises to keep me mobile.” However, it isn’t just the clinical care that made a difference for Velma “The social activities really helped me. You often see new people very distressed following a stroke. I always tell them, you are in good hands, this is a place where we all feel safe and secure, and you will too, they will take good care of you.”

This new approach means that participants receive 360 degrees of care from multiple specialists at one time, “the service is unique because we are offering a multi-disciplined approach” Dr Malik said. “It allows us to identify not only medical assistance we can offer, but also social support within the community”. Depression following a stroke is very common “A local voluntary stroke group also attend the clinic. Volunteers are invited to sit with the speech and language therapists and learn techniques they can use in the community to re-inforce the messages from the stroke clinic. It gives the patients a community connection, and on-going support outside the hospital setting.”

During each clinic, participants have a series of tests including an ECG, blood tests and a secondary stroke consultation to monitor their progress. The clinic also offers preventative measures to reduce the risk of a secondary stroke such as healthy eating and stop smoking advice.

The New Zealand Stroke Foundation recently launched a new stroke awareness campaign to encourage New Zealanders to learn the key signs of a stroke. The FAST campaign identifies the first signs of a stroke and encourages kiwis to dial 111 as soon as they recognise them. For more information about strokes visit www.stroke.org.nz.