Grant: Health System Impact Fellowships - Doctoral Western 1-year

Stroke is a leading cause of death and disability in Canada. Scientists have observed that people who suffer a stroke and are transported to the hospital by ambulance have lower rates of death and better outcomes. Because of this campaigns, like the Face Arms Speech Time (F.A.S.T) program, have been created to increase public awareness of stroke symptoms and what to do in the event of a stroke. Still we know many people have a stroke and do not use an ambulance to get to hospital. Instead they choose to wait for symptoms to go away, drive themselves, or get others to drive them. It is unclear how mode of arrival, especially outside a large metropolitan city, affects one's hospital medical care. This represents an important gap in current knowledge because we do not fully understand factors or effects associated with calling an ambulance in the event of a stroke, specifically in smaller urban or rural areas. The purpose of this study is to understand why (or why not) people call an ambulance when they or someone in their care is having a stroke and how calling an ambulance affects medical care they receive in hospital. To answer these questions, we propose to quantitatively examine a dataset of stroke patients (19,000 cases) to determine differences in ambulance usage across British Columbia. In a smaller subset of the sample (700 cases), we will determine if mode of arrival affects time to seeing a healthcare professional and treatment including brain scan. To understand the decision-making process, we will qualitatively study stroke patients by interviewing a sample of 25 persons who called an ambulance and 25 who did not. The results of this study will be important for people at risk for stroke, their caregivers, and the general public to understand why it is important to call an ambulance when a stroke is happening. This research is also important for health organizations who can use information from this work to refine services and public awareness campaigns.