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Updated: May 9, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
User experience of a centralized hyperacute stroke service: a prospective evaluation
Barry Moynihan1, Selina Paul, Hugh S Markus
1From the Stroke and Dementia Research Centre, St George's University of London, London, United Kingdom.
Stroke
|August 3, 2013
Summary
Centralized hyperacute stroke unit (HASU) care improves thrombolysis rates and patient satisfaction. While some carers experienced anxiety regarding repatriation, overall patient and carer experiences with this model were positive.
Area of Science:
- Neurology
- Healthcare Management
- Patient Experience Research
Background:
- Centralizing hyperacute stroke unit (HASU) care in London aimed to improve thrombolysis access.
- This model involved repatriation to local stroke recovery units on day 3.
- Patient and carer experiences of this centralized model were previously undocumented.
Purpose of the Study:
- To evaluate patient and carer experiences with a centralized hyperacute stroke unit (HASU) care model.
- To assess satisfaction levels across different patient discharge pathways (direct home vs. repatriation).
- To identify potential challenges and benefits associated with the centralized stroke care system.
Main Methods:
- A prospective observational study was conducted in South West London.
- Patient and carer experiences were assessed using a modified Picker Questionnaire.
- Separate questionnaires were administered to patients discharged home, repatriated patients, and their carers.
Main Results:
- Thrombolysis rates increased from 6% to 9% despite a shift to non-selected admissions.
- High satisfaction was reported by both patients and carers.
- Patients discharged directly home reported higher satisfaction than repatriated patients, who were older and had more severe strokes.
- 47% of carers reported anxiety about repatriation, though few noted an impact on patient recovery.
Conclusions:
- Centralized hyperacute stroke unit (HASU) care demonstrates good patient and carer satisfaction.
- The model effectively balances improved acute treatment access with patient experience.
- Repatriation, while causing some carer anxiety, did not significantly impact patient recovery in this study.
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