Virtual Intervention Stroke Initiative

Not Applicable

Not yet recruiting

• Conditions: Ischemic Stroke; Acute Ischemic Stroke
• Interventions: Other: Virtual assessment

• Registration Number: NCT05875389
• Lead Sponsor: Ottawa Hospital Research Institute

Brief Summary

The goal of this clinical trial is to determine if patients admitted to a primary stroke centre, such as the general internal medicine service of the Ottawa Hospitals General Campus, for acute ischemic stroke would benefit from a scheduled virtual assessment with a stroke neurologist to review investigations, results, and evaluations to identify stroke etiology, propose appropriate therapy, and guide decision-making and multidisciplinary assessment, similar to services provided to patients admitted to comprehensive stroke centres, such as the Civic Campus of the Ottawa Hospital.

Detailed Description

Patients admitted to primary stroke centres do not have access to the same level of stroke expertise on site as do patients admitted to comprehensive stroke centres, resulting in increased length of stay with implications for access to stroke rehabilitation. Virtual access to stroke experts has been used in hyperacute stroke care through programs such as Ontario Telestroke, but this has not been routinely used for acute inpatient management. The investigators propose a system to provide virtual access to the stroke neurology team to patients admitted with stroke in a primary stroke centre. Patients at the General Campus of the Ottawa Hospital are currently admitted to Internal Medicine; this includes scheduled virtual assessment with a stroke neurologist and advanced practice nurse/interdisciplinary support to review investigations, results, and evaluations to identify stroke etiology, propose appropriate therapy, and guide decision-making and multidisciplinary assessment, similar to services provided to patients admitted to the Civic Campus. This will be developed with the assistance of Internal Medicine and will utilize technologies and assessment tools and strategies already being used for provision of virtual care in other settings. The goal of this project will be to prove that patients in primary stroke centres, with the assistance of virtual care, can benefit from the expertise available at comprehensive centers throughout their stay, and that this will result in an improved quality of care with benefits for patients, hospitals, and the community.

Study Timeline

• Study First Submitted: 2023-05-09
• Study First Submitted QC: 2023-05-23
• Study First Posted: 2023-05-25
• Status Verified: 2024-04
• Last Update Submitted: 2024-04-02
• Last Update Posted: 2024-04-04
• Study Start: 2024-05-01
• Primary Completion: 2025-06
• Study Completion: 2025-06

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

• 18 years of age or older
• admitted to the general internal medicine service of the Ottawa Hospital General Campus for acute ischemic stroke
• able to participate in video assessments with necessary accommodation/facilitation for participation (particularly if stroke results in physical or communication deficits)

Exclusion Criteria

• patients who are unable, in the judgement of the study team or treating team, to participate in video assessments

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Virtual assessment	Virtual assessment	virtual assessment with a stroke neurologist/advanced practice nurse, with interdisciplinary support, to facilitate the care of patients admitted to primary stroke centres using existing tools for remote evaluation and review.

Primary Outcome Measures

Name	Time	Method
Morbidity-adjusted length of stay	Through study completion, an average of 6 months	Number of days admitted to general internal medicine

Secondary Outcome Measures

Name	Time	Method
Length of time on ALC	Through study completion, an average of 6 months	Length of time on alternate level of care