The Erie St. Clair LHIN is reducing inpatient admissions through enhanced stroke prevention strategies.

The Erie St. Clair LHIN has had the highest rates of ED visits for stroke/TIA patients in the province over the past nine years (2.1 per 1,000 LHIN population in 2011/12). In 2003/04, it also had the highest stroke/TIA inpatient admission rate (2.2 per 1,000 LHIN population), but reduced its rate dramatically to 1.4 per 1,000 LHIN population
in 2011/12 (p<0.0001).

The stroke coordinators in the Erie St. Clair LHIN attribute the decline in inpatient admissions to an integrated approach to stroke prevention across the inpatient setting and secondary stroke prevention clinics (SPCs). Each of the three counties in the Erie St. Clair LHIN has an SPC, which allows the region to provide adequate geographic
access to ambulatory prevention clinics. These SPCs receive the highest proportion of confirmed stroke/TIA patients referred directly from an ED compared to all other LHINs (29.9%; see exhibit 2.3), and have the shortest median wait times for initial visits in the province (4 days compared to 14 days provincially; see exhibit 2.6). The provision of comprehensive patient/caregiver follow-up education and support is a focus of the stroke prevention strategy within this LHIN, with 91% of SPC patients returning for follow-up visits to receive risk reduction and lifestyle modification
education (see exhibit 2.10).

The trends observed in the Erie St. Clair LHIN demonstrate that despite high stroke ED visit rates, inpatient admissions can be reduced through an increased focus on prevention strategies and appropriate utilization of SPCs.