Celebrating our Achievements 1999-2014 Executive summary www.canadianstrokenetwork.ca
Celebrating our Achievements Canadian Stroke Network 1999-2014 Our mission was to reduce the impact of stroke on Canadians through collaborations that create valuable new knowledge; to ensure the best knowledge is applied; and to build Canadian capacity in stroke. Through the formation of goal-driven, coordinated, multidisciplinary and inter-institutional teams, we have produced breakthrough biomedical, clinical, health service, and population level stroke research that is enhancing prevention and treatment. Knowledge from all areas of stroke has been synthesized, evaluated and used to develop policy and best practice recommendations. The best knowledge has been applied through translation initiatives such as the Canadian Stroke Strategy, as well as through public and professional education and advocacy, advancing stroke care across the country and improving the health of the population. Award-winning programs continue to provide training, research experience and professional development to students, researchers, clini cians, and healthcare professionals. Focus on Stroke our flag ship training program has attracted significant partner support, leveraging our investment and boosting the generation of per sonnel that are highly qualified in the field of stroke. Canada s stroke research, care, and patient communities have been united and coordinated through the formation of strong networks and partnerships. Key partners such as the Heart and Stroke Foundation have been fully engaged in the Network s major programs. Working synergistically with partners, stakeholders and collaborating organizations has enabled the Network to punch above its weight in the fight against stroke. This has attracted international attention and has established Canada as a leader. These relationships will also sustain the momentum and build on the solid foundation left by the Network to ensure a lasting impact. 1
Executive Summary 1999-2014 mission fulfilled: Discovery, commercialization (NoNO, Inc.) and clinical evaluation of NA-1 the first neuroprotective drug that is effective in humans (Science, Nature, Lancet). Gene identified that leads to the weakening of blood vessels in the brain, increasing the risk of stroke (Science). Determined the role of hemichannels in neurons linking these channels to stroke (Science). Global risk factors for stroke defined by INTERSTROKE study (Lancet). CHAP study shows a community based health promotion and prevention programme targeted at older adults can reduce cardiovascular morbidity at the population level named one of the top five health research achievements in Canada in 2012. FASTER trial shows fast assessment of stroke and transient ischemic attack prevents early recurrence (Lancet). CASES trial shows thrombolysis is an effective treatment for acute ischemic stroke in Canada. EMBRACE trial shows extended cardiac monitoring of patients with unexplained strokes detects undiagnosed atrial fibrillation, a major treatable risk factor for recurrent stroke (New England Journal of Medicine). The world s largest clinical stroke database launched in 2001 as the Registry of the Canadian Stroke Network is hosted at the Institute for Clinical Evaluative Sciences. The Registry includes data on more than 177,000 patients with acute stroke or TIA. To date, Registry data have contributed to 78 peer-reviewed publications (inc. New England Journal of Medicine, Lancet), more than 130 abstracts, 16 technical and research reports and 5 graduate theses. With partner support from the Ontario Ministry of Health and Long-Term Care, the data serve as the foundation for stroke quality of care measurement within Ontario. The Stroke Research Evidence- Based Review (SREBR) is the most comprehensive review of stroke rehabilitation literature 2
Celebrating our Achievements in the world. Since 2003, the SREBR Research Group has delivered over 500 presentations, produced 122 peer-reviewed articles that have generated more than 2,500 citations, and received 19 recognition awards. Over 1,700 peer-reviewed scientific papers published. Developed in 2001 in partnership with the Heart and Stroke Founda tion, the award winning Focus on Stroke program builds FOCUS ON STROKE Awards Partner Funding Doctoral Research HSF 47% Award 81 CSN 18% Research Fellowship 106 AstraZeneca 13% Research Scholarship 5 CIHR-Rx&D 4% New Investigator 7 CIHR/ Total 199 ICRH/IA 17% stroke research capacity and supports research training for health professionals. Partners have contributed $19M to support almost 200 trainees. More than 60% of trainees have continued to work in stroke research. Provided training opportunities for young researchers through summer studentships in Network research labs over 200 have been awarded. Through initiatives such as the i.e. annual Stroke Management, Stroke Nursing, Stroke Reha bilitation, and Stroke Review for Residents courses conducted in partnership with the Canadian Stroke Consortium, the Network has ensured the continued development of stroke professionals. TRAINEES WORKING ON CSN RESEARCH 90 80 Fellow Doctoral Masters 70 60 50 40 30 20 10 0 2000-2001 2002-2003 2004-2005 2006-2007 2008-2009 2010-2011 2012-2013 3
Executive Summary 1999-2014 CSN REVENUE CONTRIBUTIONS MILLIONS 20 18 16 14 12 10 8 6 4 2 0 Non-NCE 2000-2001 2002-2003 2004-2005 2006-2007 2008-2009 2010-2011 2012-2013 NCE In partnership with the Heart and Stroke Foundation and the Canadian Stroke Consortium, the Network established the Canadian Stroke Congress. Now in it s 5 th year, this annual forum brings together some 1,000 participants reflecting bench-to-bedside-tocommunity perspectives of stroke to exchange ideas, collaborate, and learn about innovation in stroke prevention, treatment, and recovery. Defined and implemented the Canadian Best Practice Recommendations for Stroke Care the Recommendations improved care in Canada and served as a model that other countries followed. The Canadian Stroke Strategy developed in partnership with the Heart and Stroke Foundation and provincial governments assisted provinces in adopting an integrated approach to stroke prevention, treatment, and rehabilitation. See next page Conducted the first national audit of stroke services, providing a baseline for the quality of stroke care and identifying gaps in services. Catalyzed and facilitated the expansion of Telestroke services across the country to deliver optimal stroke services to people living in remote and rural areas. Partnered with Blood Pressure Canada and Hypertension Canada to advocate for reducing the high levels of sodium in the food supply a cause of high blood pressure, the leading controllable risk factor for stroke. The Network s media campaign raised public awareness of the issue from near zero to 90% and led to the dev elopment by Health Canada of a Sodium Reduction Strategy for Canada. 4
Celebrating our Achievements THE CANADIAN STROKE STRATEGY Newfoundland and Labrador British Columbia Alberta Manitoba Québec Ontario Saskatchewan Prince Edward Island New Brunswick Implementation complete or nearly complete Implementation substantially complete Implementation partially complete 5 Nova Scotia
Executive Summary 1999-2014 British Columbia ED Stroke /TIA protocol Telestroke Stroke recovery support $4.5M annual funding Alberta Regional networks Telestroke, TIA hotline Online training Quality improvement program Improved rural stroke care access Community vascular risk program Saskatchewan Piloting integrated program Regina stroke rehabilitation unit Acute stroke care pathway Telestoke initiated Manitoba Prevention clinic by telestroke in Northern Region Regional Telehealth collaborative Development of 15 minute triage for suspect strokes Ontario tpa rate increased from 10% (2003) to 39% (2013) Integrated care systems Metrics and accountability agreements $30M annual funding Québec Led by provincial government Regional stroke coordinators Telestroke pilot Annual stroke summits Paramedic training New Brunswick Province-wide telestroke Stroke centres in regions with stroke units Stroke monitoring framework Stroke awareness campaign Community re-integration under review Nova Scotia Stroke unit designated in Capital District District stroke care coordinators Annual Atlantic Canada stroke conference $3M annual funding Prince Edward Island $3M over 4 years committed Strategy largely implemented Telestroke initiated Newfoundland and Labrador Stroke units in Eastern and Western Regions Prevention clinic and rehabilitation unit Telestroke in development 6
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