Stroke Diagnosis and Management at Albury/Wodonga Health

Policies and procedures only have value when they are followed and executed. Otherwise, they are less useful than a hat in a thunderstorm.

Despite improvements to pathways for stroke management at Albury Wodonga Health promising better patient outcomes as touted in the Border Mail in 2017 (Albury-Wodonga Health stroke unit reconfigured for better patient outcomes; 29 June 2017), patients continue to be mismanaged by failures of the health service to adhere to the touted policies and strategies.

The reconfiguration reported in 2017 detailed how the Albury-Wodonga Health Service had been utilising the Victorian Stroke Telemedicine service, a specialty service where on-call neurologists are available to rural and regional health services when patients are assessed for treatment for a suspected stroke.

The service by all accounts in theory bridges the gap between the level of patient care provided for metropolitan stroke victims and their rural and regional counterparts. The service’s Neurologists can provide assessments or recommend transfer to Melbourne for urgent intervention.

At the time of the report in 2017, the unit coordinator detailed how the unit had been configured so that stroke patients would be taken to Albury for treatment, with Wodonga serving as the rehabilitation unit. This is not, on any level an improved outcome.

But what happens for patients who are taken to Wodonga with stroke symptoms in the first instance instead? One might assume that the same service is available at Wodonga. No, they don’t!

Documents obtained by Kate Williams Medical Law Partnership in NSW Supreme Court proceedings indicate that the stroke treatment pathway is only available for patients presenting at Albury. This potentially has catastrophic consequences for stroke victims presenting to Wodonga either themselves, or when taken by Ambulance.

Once again, the dual-site approach and splitting of services seems to have led to worse outcomes for those unlucky patients who don’t receive appropriate triaging. It is important to ask, was this change communicated to the Ambulance services? Do paramedics know that they cannot necessarily take ‘000’ calls to the closest hospital, but instead the hospital geared for acute care?

Once more, ‘patient outcomes’ are said to have been improved by this program – but what about the outcomes for patients who happen to be on the wrong side of the Murray River when they are suffering from a stroke?

The Border Mail Article can be found here (paywall): https://www.bordermail.com.au/story/4758135/placed-to-give-best-outcomes/