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Provision of stroke thrombolysis services in New Zealand: changes between 2011 and 2016.

Abstract To obtain an overall picture of the organisation of stroke thrombolysis provision in New Zealand hospitals and compare changes between 2011 and 2016.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the new zealand medical journal
Publication Year Start




PMID- 28384148
OWN - NLM
STAT- MEDLINE
DA  - 20170406
DCOM- 20170418
LR  - 20170418
IS  - 1175-8716 (Electronic)
IS  - 0028-8446 (Linking)
VI  - 130
IP  - 1453
DP  - 2017 Apr 07
TI  - Provision of stroke thrombolysis services in New Zealand: changes between 2011
      and 2016.
PG  - 57-62
AB  - AIMS: To obtain an overall picture of the organisation of stroke thrombolysis
      provision in New Zealand hospitals and compare changes between 2011 and 2016.
      METHODS: Surveys were distributed to all New Zealand district health boards
      (DHBs) in 2011 and 2016, and included questions about the infrastructure,
      staffing, training, guidelines and audit provided for stroke thrombolysis.
      RESULTS: Responses were received from all DHBs, with 86% offering stroke
      thrombolysis in 2011 and 100% in 2016. In 2016, thrombolysis rosters of large
      DHBs (those with a population >250,000 people) had a mean (range) of 14 (5-34)
      clinicians, approximately double that of medium-sized DHBs (population
      125-250,000) who had eight (3-15) and small DHBs (population <125,000) with
      seven, (2-13) clinicians. While a similar distribution of senior medical officer 
      clinical specialty was seen across medium and small DHBs in both years, large
      DHBs in 2016 had a higher number of neurologists (5, 1-12) and an increasing
      number of general physicians (8, 0-30) rostered to provide thrombolysis compared 
      to 2011. Thrombolysis services at medium and small DHBs are chiefly managed by
      general physicians and geriatricians, while telestroke support was only available
      in three medium-sized DHBs. In 2016, all hospitals had developed thrombolysis
      guidelines and audited thrombolysed patients in the National Stroke Thrombolysis 
      Register, which is an improvement compared with 2011 when only seven (39%) DHBs
      reported regular audit. Challenges in staffing and training remain greatest in
      smaller and geographically isolated DHBs. CONCLUSION: While there have been
      improvements in the provision of stroke thrombolysis throughout New Zealand,
      regional variations in service quality remains. The needs for better solutions to
      geographical barriers and formal training must be addressed as priorities.
FAU - Liu, Qiliang
AU  - Liu Q
AD  - Trainee Intern, Departments of Neurology, Auckland City Hospital and University
      of Auckland.
FAU - Ranta, Annemarei Anna
AU  - Ranta AA
AD  - Neurologist and National Clinical Leader Stroke, Department of Neurology,
      Wellington Regional Hospital and University of Otago.
FAU - Abernethy, Ginny
AU  - Abernethy G
AD  - National Stroke Network Coordinator, Stroke Foundation of New Zealand.
FAU - Barber, P Alan
AU  - Barber PA
AD  - Professor, Neurologist and Stroke Service Clinical Lead, Department of Neurology,
      Auckland City Hospital and University of Auckland, Auckland.
LA  - eng
PT  - Journal Article
DEP - 20170407
PL  - New Zealand
TA  - N Z Med J
JT  - The New Zealand medical journal
JID - 0401067
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - After-Hours Care/trends
MH  - Brain Ischemia/complications/*drug therapy
MH  - Fibrinolytic Agents/adverse effects/*therapeutic use
MH  - General Practitioners/education/supply & distribution
MH  - Health Services Accessibility/organization & administration/*trends
MH  - Hospitals, District/*organization & administration/trends
MH  - Humans
MH  - Medical Audit/trends
MH  - Medical Staff, Hospital/education/*organization & administration/trends
MH  - Neurologists/education/supply & distribution
MH  - New Zealand
MH  - Organizational Policy
MH  - Personnel Staffing and Scheduling
MH  - Practice Guidelines as Topic
MH  - Stroke/*drug therapy/etiology
MH  - Telemedicine/trends
COI - Nil.
EDAT- 2017/04/07 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/07 06:00
PST - epublish
SO  - N Z Med J. 2017 Apr 7;130(1453):57-62.

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