“It is so satisfying to make such a difference.” 

The PEI Secondary Stroke Clinic is making a difference.

Dr. Heather Williams could see things needed to change. She's a neurologist on Prince Edward Island. 

“Before 2017, almost every patient who arrived at an Island emergency department with stroke was admitted to hospital,” she said. “At the time, that was the best way to ensure they would be seen by a neurologist. But that sometimes took weeks, and it was filling our precious hospital beds with people who didn’t necessarily need to be there.” 

The new focus, she said, had to be on preventing secondary strokes while keeping hospital beds for those who needed them. 

“Time is crucial for stroke,” she said. “The highest chance of a secondary stroke event is within 18 days of the first event. We ran a pilot clinic in Summerside based on that idea that was so successful, it was expanded province-wide.” 

Kyra Johnston is a neurology nurse at the Secondary Stroke Clinic in Charlottetown. 

“We work hard to ensure each stroke patient sees a neurologist as soon as possible. The first morning after their referral, we examine their medical history and calculate their risk factors. We do a phone consultation and determine their risk of recurrence. Highest-risk patients are usually seen by the neurologist that same day.” 

     – Kyra Johnston, neurology nurse

“It’s made a huge difference,” said Dr. Williams. “Since these clinics opened, we’ve seen a decrease in hospitalization from transient ischemic attack (TIA) on the Island by 46 percent. We’re really proud of that.” 

Before working at the Secondary Stroke Clinic, Johnston worked for many years in the emergency department. She says it was important to get buy-in from emergency physicians on the importance of the new system. 

“I know very well the challenges in acute care,” she said. “They need to be confident when referring patients to us, we’ll work quickly to do what’s needed. And we do.” 

Patients notice the difference, too. 

“Patients regularly say they’re shocked by how well this clinic works,” said Johnston. “They often see a specialist within a day of their discharge. That shows we take their care seriously. This clinic is just a practical solution to a long-standing problem. It's so satisfying to make such a difference.” 

The clinic is now supported by two neurologists and treats approximately 300 patients per year. 

“We have a great team,” said Dr. Williams, “And we’re all working towards the same goal of preventing secondary stroke. That can be a nurse working to educate patients on lowering their blood pressure or managing their cholesterol. It can be referring patients to the stroke rehab program, for those with lingering issues. It’s the whole package, and it all comes from approaching post-stroke care in a different way.” 

A stroke is a medical emergency. Do not drive to the hospital. Call 9-1-1. Learn the signs of stroke. Think FAST: Face: is it drooping? Arms: can you raise both? Speech: is it slurred or jumbled? Time to call 9-1-1 right away. 

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Published date: 
February 9, 2023
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