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​Stroke & Rehabilitation
Medicine Program

 

The RVH stroke program is home to the Enhanced District Stroke Centre which includes RVH clinical stroke services and regional planning responsibilities (Central East Stroke Network). We are dedicated to providing the best possible experience for those who are at risk for having a stroke and for those who require care and rehabilitation after a stroke.

Stroke is a medical emergency. Patients who experience any of the FAST signs of stroke should call 911. Face is it drooping? Arms can you raise both? Speech is it slurred or jumbled? Time to call 911 right away.

Eligible patients from across Simcoe County are transported to RVH for assessment and consideration of hyperacute stroke therapy. The goal of these therapies is to improve patient recovery by dissolving and/or removing the clot in the brain:

 

Thrombolytic therapy is used to dissolve the clot. It uses the drug tPA, which must be given at RVH within 4.5 hours from when the stroke started. Patients who are eligible and receive tPA will be transferred back to their home hospital after 24-48 hours of monitoring. Some of these patients may also be considered potential candidates for Endovascular therapy (EVT).

 

  • Endovascular therapy (EVT) is used to remove the clot. EVT is usually completed within 7.5 hours. Patients who are potential candidates for EVT will be transferred to an Endovascular Stroke Centre in Toronto. Patients who are transferred to Toronto for EVT are transferred to a stroke unit close to home for care 48 hours post EVT. Stroke units in Simcoe County are located at RVH and Orillia Soldiers Memorial Hospital.

A special medical team must screen and assess patients to determine if they are eligible for tPA and/or EVT. Patients who are determined not eligible for tPA or EVT will be transferred to their home hospital directly from the RVH Emergency Department.

The earlier treatment is provided the better. Time is crucial. Time is Brain.

RVH provides best practice interprofessional inpatient and outpatient stroke care. Inpatient services are provided on the Integrated Stroke and Rehabilitation Unit. Outpatient services are available through the Stroke Prevention Clinic and Day Rehabilitation Program.

 

Area's of care

Inpatient

Integrated Stroke Unit and Rehabilitation Inpatient


Contact Us

Integrated Stroke Unit​ and Rehabilitation 
Phone: 705-728-9090 Ext. 47350

Manager: Shelley Debison
 
Phone: 705-728-9090 Ext. 47305
Fax: 705-797-3073

Outpatient

Rehabilitation Day Program
Ambulatory Rehabilitation Day Program Referral.pdf


Contact Us

Rehabilitation Day Program
Phone: 705-728-9090 Ext. 47347

Hours of Operation: 

Monday-Tuesday:  8:30 a.m. - 4:00 p.m.

Wednesday: 8:30 a.m. - 12:15 p.m.
Friday: 8:30 a.m. - 4:00 p.m.

Location: Register at Treatment Clinic Recurring Check In on Level 1 before going to Rehabilitation Day Program. From Treatment Clinic Recurring Check In turn left following the Blue Navigation line. Rehabilitation Day Program is located at the end of the hallway on your left.
Note: Press the accessibility door button to enter the clinic.

Outpatient

Stroke Prevention Clinic


​Contact Us

Stroke Prevention Clinic
Phone: 705-728-9090 Ext. 23300
Fax: 705-728-3039 

Hours of Operation:
Monday and Thursday: 8 a.m. - 4 p.m.

Our Partner

Central East Stroke Network


Contact Us

Regional Director, Central East Stroke

Network: Cheryl Moher
Phone: 705-728-9090 Ext. 46300

Location
201 Georgian Drive, Barrie, ON L4N 6M2


 

​Resources

Please visit the links below for more information on Stroke.

Post Stroke Checklist

North Simcoe Muskoka Self-Management Programs

The Living with Stroke Program

Stroke Recovery Barrie

North Simcoe Muskoka Health line

Stroke Engine Family

Heart and Stroke

 

Guiding Principles

• Provide patient and family centered care that reflects the RVH MY CARE strategic plan

• Provide care that reflects the Canadian Best Practice Recommendations for Stroke Care

• Value roles and perspectives of patients and families in the recovery journey

• Provide compassionate and hopeful care and instill trust for patients and families

• Work together with patients and families and think big to maximize recovery and optimize quality of life following stroke

• Provide leadership and collaborate with our community partners to advance stroke care within the Central East Stroke Region (Simcoe, Muskoka, York, Durham, Haliburton, Kawartha, and Pine Ridge geography which is included within the North Simcoe Muskoka, Central and Central East Local Health Integration Networks)

 

Goals & Objectives

RVH provides cross continuum stroke services through hyperacute, acute and rehabilitation
(inpatient and out-patient) and stroke prevention services. Across these settings, the overarching goals of the stroke program are to:

• Provide best practice stroke care that is supported by clinical pathways, validated assessments and comprehensive care planning that reflects the Canadian Best Practice Recommendations for Stroke Care

• Conduct timely interprofessional assessment of all patients admitted using validated assessment tools

to own our clinical practice and ensure stroke care expertise within the interprofessional team through annual maintenance of stroke care competencies

• Work together with families and caregivers to address individualized education and information needs;

• Work together with our community partners to achieve smooth transitions across the stroke care continuum, ensuring quality and timely care in the right setting

 

Hyper-acute (Emergency phase) – Our goals are to:

• Provide timely access to appropriate assessment, screening and diagnostic testing that meets

Canadian Best Practice Recommendations for Stroke Care (Hyperacute Standards- Section 3.0)

• Provide thrombolysis (tPA) to eligible patients within 30 minutes of arrival to RVH Emergency Department and refer eligible endovascular treatment patients within 45 minutes of arrival to RVH Emergency Department

• Refer all non-admitted patients with Transient Ischemic Attacks/Nondisabling strokes to the RVH Stroke Prevention Clinic

 

Acute Care - Our goals are:

• Complete nursing admission assessments, Falls Risk and Pressure Ulcer Risk assessments within
24 hours

• Complete interprofessional team assessments on all patients with stroke within 48 hours of admission using validated assessment tools 

• Minimize complications of stroke through the use of evidence based care pathways, validated screening tools and comprehensive care planning

• Initiate referral to vascular surgery for consideration of carotid endarterectomy

• Complete the Alpha Functional Independence Measure (Alpha FIM®) on all patients on day 3 of admission to support triage to the most appropriate care setting within the recommended time frames

• Access stroke prevention services for medical optimization, education, self-management and healthy lifestyle support, risk factor management

 

Inpatient Rehabilitation - Our goals are to:

• Work together with patients and their families

• Provide best practice interprofessional rehabilitation, tailored to individual needs and functional goals;

• Empower patients and families to be active partners in the rehabilitation journey and goal setting process;

• Facilitate seamless transitions to the community through comprehensive discharge planning that includes with patients and their families and community partners

• Ensure effective communication and linkages between the Integrated Stroke Unit, the Rehabilitation Day Program and the North Simcoe Muskoka Home and Community Care Program

• Our discharge planning processes and evaluate the effectiveness of transitions through post discharge phone calls

 

Community Reintegration - Our goals are to:

• Provide patient and families with information about NSM Home and Community Care, community rehabilitation and other community resources, facilitate linkages and initiate referrals

• Offer eligible patients timely access to hospital based outpatient inter-professional stroke rehabilitation through the Rehabilitation Day Program

• Work together with community partners to facilitate ongoing self-management, health promotion and successful community reintegration and lifelong recovery for patients and their families

• Think big and work together with our community partners to address current gaps in stroke care within Simcoe County, NSM LHIN and Central East Stroke Region

 

Stroke Prevention Clinic

• Provide early access to multidisciplinary assessment, diagnostic testing, treatment, and referral for patients who have been identified at high risk for stroke

• Provide education on lifestyle and vascular risk management, stroke prevention and warning signs
for stroke

• Facilitate linkages to community programs including community exercise programs and cardiovascular rehabilitation for secondary prevention and chronic disease management

 

Outpatient Day Rehabilitation

Admission criteria for Rehabilitation requirements:

 

Patient admission into the program is dependent on meeting the following criteria.

The patient must:

· Be 18 years of age or older

· Have a diagnosis of: stroke, or amputation requiring prosthetic training.  Patients with neurodegenerative disease as their admitting diagnosis are not eligible for admission.

· Be referred to the program by a physician, or nurse practitioner. The referral must be complete and may be returned if additional information is required

· Be medically stable and able to tolerate a minimum of three hours of therapeutic activity per day

· Have experienced the neurological event for which he or she is referred within the past 3 months and/or be a new prosthetic limb user

· Require the services of one of the following: Occupational Therapy, Physiotherapy, Speech Language Pathology, Registered Nursing, Social Work

· Not be receiving inpatient hospital care

· Not be a resident of a long term care facility

· Reside within the provider service area for Royal Victoria Regional Health Centre or has received care for the referring diagnosis at RVH

· Demonstrate rehabilitation potential and have functional goals that are attainable in a three month period

 

Signs of Stroke: