Virtual Intervention Stroke Initiative

Study Overview
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Brief Summary
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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
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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.

Official Title
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Virtual Intervention Stroke Initiative by Ottawa Neurology

Conditions
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Ischemic Stroke, Acute Ischemic Stroke

Intervention / Treatment
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* Other: Virtual assessment


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Virtual assessment<br>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. | Other: Virtual assessment<br>* 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.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Morbidity-adjusted length of stay | Number of days admitted to general internal medicine | Through study completion, an average of 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of time on ALC | Length of time on alternate level of care | Through study completion, an average of 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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telemedicine, virtual care