Poster Presentation Australian and New Zealand Stroke Organisation Conference 2026

Early Implementation of the Queensland Telestroke Service: Workflow Metrics, Safety and First Six Month vs Extended Phase Comparison (#142)

Valene Hii 1 2 , Claire Muller 2 , Andrew Wong 2 3 , Michael Roizman 1 2 , Chloe A. Mutimer 1 4 , Raka Datta 1 2 , David D.G. Palmer 1 5 6 , Rodrigo Tomazini Martins 1 7 , Brett Travers 1 6 , Angela Dos Santos 8 9 , Ferdinand Miteff 10 , Shenal Appuhamy 11 , Sarah Attwa 11 , Dhananjay Parshuramkar 12 , Jodie Hopkins 12 , Belinda Weich 13 , Maduka Sanjeewa 13 , Nirindu Weerakoon 13 , Andrew Charmley 14 , Ravindra Urkude 14 , Talitha Francis 1 , Torrie Scott-Paku 1 , Alice Graham 1 , Aylissa Canning 3 , Caitlin Kearney 1 , Luke Wainwright 1 , Carlos Garcia‐Esperon 1
  1. Queensland Telestroke Service, Metro North Health, Herston, QLD, Australia
  2. Department of Neurology and Stroke, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
  3. Queensland Stroke Clinical Network, Clinical Excellence Queensland, Brisbane, QLD, Australia
  4. Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, Parkville, VIC, Australia
  5. The Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
  6. Department of Neuroscience and Rehabilitation, Sunshine Coast Health, Birtinya, QLD, Australia
  7. Department of Neurology, Mater Hospital, Brisbane, QLD, Australia
  8. Faculty of Medicine and Health, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
  9. Australian Stroke Alliance, Melbourne Brain Centre at Royal Melbourne Hospital, Parkville, VIC, Australia
  10. John Hunter Hospital, Hunter New England Health, New Lambton Heights, NSW, Australia
  11. Hervey Bay Hospital, Wide Bay Health and Hospital Service, Pialba, QLD, Australia
  12. Bundaberg Hospital, Wide Bay Health and Hospital Service, Bundaberg Central, QLD, Australia
  13. Mackay Base Hospital, Mackay, QLD, Australia
  14. Department of Neurology, Townsville University Hospital, Douglas, QLD, Australia

Background: The Queensland Telestroke Service (QTS) provides 24/7 specialist support to regional hospitals, improving access to time-critical stroke therapies for non-metropolitan patients.

Aim: To describe early QTS performance (uptake, safety, and workflow) and compare metrics from the first six months of implementation against the extension phase.

Methods: We analysed accepted QTS consultations between October 2024 and March 2026. Safety was assessed via 24-hour post-treatment NCCT scans for thrombolysed patients. First six months and extension period data were compared using standard non-parametric and chi-square statistical tests.

Results: Of 780 referrals, 321 (41.2%) were triaged as ineligible and stood down. The accepted 459 (58.8%) cases were reviewed, with 312 (68%) diagnosed with ischaemic stroke. Reperfusion therapy was administered to 93 (20.4%) patients: 19 (4.1%) combined thrombolysis/endovascular thrombectomy (EVT), 60 (13.1%) thrombolysis only, and 14 (3.1%) EVT only. Safety was reassuring, with Parenchymal Haematoma Type 2 (PH2) occurring in 3 (3.8%) of 79 thrombolysed patients. Overall median door-to-CT time was 41 minutes [30-57], and door-to-needle time was 94 minutes [82-122]. Comparing the first six months to the extended phase, there was no significant difference in door-to-CT (45.5 vs 43 mins, p=0.599) or door-to-needle times (96 vs 102 mins, p=0.964).

Conclusion: QTS safely facilitated reperfusion therapy for a high proportion of eligible regional patients. QTS lead service improvements in workflow metrics were maintained from the initial first six months post implementation period to extended phase. Ongoing site-level audit, feedback and repeated education are required to improve treatment times to reach the national targets.