Background: Access to organised stroke unit care in regional hospitals is limited. BUILDS, a novel tele-stroke unit model, was piloted at Echuca Regional Health (ERH) in 2021, and implemented at North West Regional Hospital (NWRH) in 2023.
Aims: To compare key variables in BUILDS across two hospitals during the project implementation phase.
Methods: Relevant variables were extracted from implementation phase consultation records (11 months data)
Results: BUILDS provided funding for a part-time stroke coordinator and virtual ward round by a stroke neurologist during weekdays at both hospitals. NWRH was supported by one existing clinical nurse consultant position and two general physicians with interest in stroke.
110 (89% initial) vs 107 consultations (69% initial) were conducted at NWRH and ERH respectively. Median age was 76 (IQR 67-83) and 73 (IQR 65-82) at NWRH and ERH respectively. Median times for pre-consultation discussion were 15 minutes (IQR 10-20) NWRH and 10 minutes (IQR 10-15) ERH. Median time for patient consultation was 10 minutes for both sites.
Diagnosis was revised 14% (NWRH) compared to 29% (ERH). Medications were revised for 44% NWRH and 48% ERH. In eight (NWRH) and seven (ERH) instances changes present on imaging were identified and reviewed during case discussion but not previously identified in the radiology reports. 8/110 NWRH and 14/107 ERH consultations had further imaging ordered, with investigations cancelled in 9/110 NWRH and 13/107 ERH cases.
Conclusion: Tele-stroke unit model improves diagnostic accuracy, care provision and provides external quality assurance in imaging interpretation for stroke patients in regional hospitals.