Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

Stroke unit certification is associated with higher stroke unit access rates and faster reperfusion metrics. (139450)

Skye Coote 1 , Leah Pett 1 , Melita Stirling 1 , Andrew Wong 2 3 , Tanya Frost 4 , Ben Clissold 5 6 7 , Julie Morrison 8 , Kate Paice 8 , Mulugeta Birhanu 5 8 , Rohan Grimley 9 10 , Dominique Cadilhac 5 8 , Timothy Kleinig 11
  1. Evidence, Quality and Research, Stroke Foundation, Melbourne, Victoria, Australia
  2. Neurology and Stroke, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
  3. Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
  4. Neurology , Eastern Health, Ringwood East, VIC, Australia
  5. Monash Health, Melbourne, VIC, Australia
  6. Barwon Health, Geelong, VIC, Australia
  7. Monash University, Clayton, VIC, Australia
  8. The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
  9. Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  10. School of Medicine, Griffith University, Birtinya, Queensland, Australia
  11. Neurology , Royal Adelaide Hospital, Adelaide, South Australia, Australia

Background/Aims

Pre-2023, “stroke centre” designation in Australia was self-assigned. In 2023, the Australian Stroke Coalition founded a Stroke Unit Certification program to externally evaluate hospitals against consensus-based stroke-centre criteria. To date, 27 hospitals have achieved certification. We aimed to assess the association of certification with hospital performance, in relation to the 30/60/90 National Stroke Targets.

Methods

Retrospective observational study using Australian Stroke Clinical Registry (AuSCR) data to compare stroke care metrics (reperfusion timeliness and stroke unit access) between hospitals that had achieved Certification and those that had not. Reported data up to 2024 are shown. 2023-2025 data will be presented. Wilcoxon rank-sum test was used for continuous variables and a Chi-square test for the categorical variable.    

Results

Certified stroke centres by 2024 (n=19, n=9,184 episodes) demonstrated better performance on all metrics compared with non-certified sites (n=43, n=10,568 episodes). Thrombolysis door-to-needle times were 29 minutes faster (median 56 vs non-certified 85 minutes, P<0.001). Thrombectomy door-to-puncture times were shorter for direct presentations (median 99 vs non-certified 121 minutes, P<0.001) and interhospital transfers (median 35 vs non-certified 45 minutes, P<0.001). Door-in-door-out times were faster in certified metropolitan hospitals (median 94 vs non-certified 100 minutes, P<0.001), but similar for regional hospitals (median 122 vs non-certified 128 minutes, P=0.92). Stroke unit access rates were greater in certified centres (86% vs non-certified 74%, P<0.001).  

Conclusion

Our preliminary data demonstrates that external certification of hospitals treating acute stroke is associated with improved quality of care, as evidenced by better performance in the 30/60/90 National Stroke Targets.