Background: Stroke Units (SUs) improve survival and functional outcomes. Before 2024, stroke care at Maroondah Hospital was delivered by a shared General Medicine/Neurology bed card, with stroke nursing support at 0.2 FTE.
Aim: To describe the implementation of SU care spearheaded by a new 0.8 FTE Stroke Coordinator role since February 2024. There was no increased FTE to neurology/stroke medical staff or allied health team during the same period.
Methods: A phased quality improvement approach was undertaken. Standard SU interventions such as co-locating SU beds and standardising care pathways were used, as well as enhancing reperfusion preparedness and strengthening ward and emergency nursing capability. The Stroke Coordinator led education delivery, facilitated multidisciplinary coordination, and monitored performance. Standard SU metrics from 2022 were compared to those of 2025.
Results: Admission to SU increased to 89%, up from 65%. Swallow screen improved from 14% to 75%. Appropriate glucose and fever management improved from 10% to 50% and 0% to 100%, respectively. Three patients received thrombolysis onsite who otherwise would be transferred out. Physiotherapy and occupational therapy assessments within 48 hours of admission increased by 75%. Coordinated discharge care planning increased from 68% to 95%. In this context, SU at Maroondah Hospital was certified as a Primary Stroke Centre in March 2026.
Conclusion: Implementation of a dedicated SU supported by a Stroke Coordinator strengthened the quality and reliability of stroke care at Maroondah Hospital. Early results indicate a positive improvement trajectory and support scalability to similar services.