Realizing Stroke Unit Access For Everyone : Access To Acute Stroke Units Across a Large and Populous Geographic Region
Bibliographic record
Abstract
BackgroundEvidence supporting the efficacy of stroke unit care for persons post-stroke was solidified with the release of the Stroke Unit Trialists Collaboration in 2007. Although planning, development and implementation of stroke units within designated stroke centres was becoming more common at the time, access to stroke unit care in non-designated and community hospitals remained limited. Since 2009, in Central South Ontario, Canada stroke unit development has been prioritized as a key strategic goal to optimize access to best practice stroke care for all.ObjectiveTo demonstrate integration strategies that resulted in fulsome stroke unit access for 2.2 million people across approximately 11,945 square kilometers in the Central South Region. MethodsFacilitated by the Central South Regional Stroke Network, senior leaders for hospitals in the region endorsed the ideal of stroke unit care for all persons with stroke. Through geographically unique collaborations, stroke flow algorithms and expanded capacity, efforts were made to achieve this goal.ResultsAs a result, currently 20 of 22 (91%) individual hospitals have agreements to either transfer out or accept patients to a dedicated acute stroke unit. ConclusionBy fall of 2018, with the addition of a stroke unit within one local hospital, as well as a regional re-routing agreement for stroke patient transfer within another local community hospital, this strategic goal will be achieved. Through the removal of organizational and geographic barriers, all persons with stroke within the Central South Region will have access to best practice stroke unit care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.040 | 0.029 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.047 | 0.056 |
| Open science | 0.030 | 0.058 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".