Saskatchewan Health

About: Saskatchewan Health is a government organization based out in Regina, Saskatchewan, Canada. It is known for research contribution in the topics: Population & Health care. The organization has 442 authors who have published 489 publications receiving 7728 citations.

Implementation of a provincial acute stroke pathway and its impact on access to advanced stroke care in Saskatchewan.

Abstract: Background For ischaemic stroke, outcome severity is heavily time dependent. Systems of care need to be in place to ensure that patients with stroke are treated quickly and appropriately across entire health regions. Prior to this study, the province of Saskatchewan, Canada did not have a provincial stroke strategy in place. Methods A quality improvement project was undertaken to create and evaluate a provincial stroke strategy. The Saskatchewan Acute Stroke Pathway was created using a multidisciplinary team of experts, piloted at five stroke centres and then implemented provincially. The number of stroke alerts, door-to-imaging, door-to-needle, door-to-groin puncture times and treatment rates were collected at all centres. Improvements over time were analysed using run charts and individuals control charts. Results The number of stroke alerts province-wide trended upwards in the last 6 months of the study. There were no clear trends or shifts in the proportion of stroke alerts treated with alteplase or endovascular therapy. Across the province, the weighted mean door-to-imaging time decreased from 21 to 15 min, the weighted mean door-to-needle time decreased from 62 to 47 min and the mean door-to-groin puncture time decreased from 83 to 70 min. There was high variability in the degree of improvement from centre to centre. Conclusions The implementation of a province wide acute stroke pathway has led to improvement in stroke care on a provincial basis. Further work addressing intercentre variability is ongoing.

Development and clinical feasibility testing of the Pain Treatment Planning Questionnaire

Abstract: Abstract Background Chronic pain is common in people with bleeding disorders and can complicate clinical management, impair quality of life, and contribute to disability. People living with bleeding disorders often seek advice on pain management from the bleeding disorder treatment team; however, lack of condition-specific assessment tools to guide clinical communication about pain are a barrier to care. Aims To develop and examine the clinical feasibility of a patient-reported outcome (PRO) tool designed to facilitate pain assessment and support clinical communication about pain for adults attending outpatient bleeding disorder clinics. Methods Tool development involved patient cognitive interviews and item refinement by a multidisciplinary clinician and patient working group. Clinical feasibility of the tool was evaluated with a survey of a small clinical sample in an outpatient bleeding disorder clinic. The Pain Treatment Planning Questionnaire (PTPQ) contains 28 items on the pain experience and treatments used to manage or prevent pain. Results Participants completing the feasibility testing (n=42, 62% male) reported mild mean pain scores (usual pain μ=2.4, SD=2.0) with the majority (57.1%) reporting persistent pain in the past 30 days. Median PTPQ completion time was five to seven minutes and mean item response rate was 95.2%. The majority (95.2%) of participants found the questionnaire easy to understand, reported no difficulty understanding items, and recommended no changes to the questionnaire. Conclusions Preliminary testing among a small sample in a clinical setting suggests that the PTPQ is a clinically feasible, acceptable, condition-specific PRO pain assessment tool for adult patients with bleeding disorders. Further testing is required to determine if the PTPQ affects treatment decision-making and patient outcomes.