The Ontario Stroke Network (OSN) and the Institute for Clinical Evaluative Sciences (ICES) have established the first-ever benchmarks for acute stroke care delivery in Ontario.

In the article, Benchmarks for Acute Stroke Care Delivery (to be published in Volume 25, Issue 6 of the International Journal for Quality in Health Care), the authors developed data-derived benchmarks for acute stroke quality indicators.

“Benchmarks for key acute stroke indicators reflecting best practices that are key to driving improvement,” said Ruth Hall, ICES Adjunct Scientist and one of the authors of the article. “It wasn’t until recently that we have been able to collect a large enough sample of acute stroke care across all hospitals to be able to establish benchmarks. The benchmarks show our Ontario hospitals are performing in delivering best practice acute stroke care and promote a culture of improvement to strive for excellence.

Despite widespread interest in many jurisdictions in monitoring and improving the quality of stroke care delivery, benchmarks have not been established.

Hall said now that benchmarks for nine hospital-based acute stroke care quality indicators have been established, they can be used in the development of standards for quality improvement initiatives. “If you don’t measure and report performance, how can improvements be made and excellence achieved?”

The following benchmarks were derived:
  • neuroimaging within 24 hours, 98%;
  • admission to a stroke unit, 77%;
  • thrombolysis among patients arriving within 2.5 hours, 59%;
  • carotid imaging, 93%;
  • dysphagia screening, 88%;
  • antithrombotic therapy, 98%;
  • anticoagulation for atrial fibrillation, 94%;
  • antihypertensive therapy, 92%; and
  • lipid-lowering therapy, 77%.


“If you don’t measure and report performance, how can improvements be made and excellence achieved?”


“The Ontario Stroke Network benchmarks help establish common goals for clinicians and health care leaders which accelerates the continuous improvement of stroke care,” said Jim Lumsden, Champlain Regional Stroke Network Director. “Thanks to this important work we are achieving our vision of fewer strokes and better outcomes for stroke patients in Ontario.”

The Achievable Benchmark of Care (ABC TM) methodology was used to create benchmarks based on the performance of the upper 15% of patients in the top performing hospitals.

Benchmarks were calculated for rates of neuroimaging, carotid imaging, stroke unit admission, dysphasia screening, and administration of stroke-related medications.

About OSN

The Ontario Stroke Network (OSN,, created in 2008, is a non‐profit organization funded by the Ministry of Health and Long‐Term Care. The OSN provides provincial leadership and planning for the continuum of stroke care in Ontario – from health promotion and stroke prevention to acute care, recovery, rehabilitation and reintegration.  OSN is committed to creating innovations in stroke prevention and care and regularly evaluates the stroke system, partners to achieve best practices, and promotes excellent stroke care and vascular health while advocating for fewer strokes and better outcomes.

For the latest OSN news, visit or follow us on Twitter: @ONStrokeNetwork.

About ICES

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario.

Patrick Moore
Communications Manager, Ontario Stroke Network
(c) 416-455-7394