title: Rural Organisation of Acute Stroke Teams project.
abstract: BACKGROUND
  Improving the care of stroke patients is a national priority for the health system in Australia. In rural areas the challenges may be greater. Although best-practice guidelines for acute and subacute stroke care are well established, their general uptake appears to be limited and implementation strategies are required to promote the use of this evidence-based care. The Rural Organisation of Australian Stroke Teams (ROAST) project sought to promote the evidence-based stroke practice in rural hospitals.
  
  
  METHODS
  This was a prospective observational project designed to improve the services provided to rural stroke patients, primarily through better organisation of care on general medical wards and emergency departments. Using recognized support strategies, we encouraged the use of nationally recognized key performance indicators and provided audit and feedback of adherence to these indicators to participating hospitals.
  
  
  RESULTS
  Six Victorian hospitals participated in this initial phase of the ROAST project. Information was collected on 348 patients. Ten of the 11 indicators showed greater than 10% improvement in adherence levels and by the end of the project period compared favourably to levels of adherence described in metropolitan hospitals.
  
  
  CONCLUSIONS
  The ROAST projected supported a network of clinicians to implement evidence-based guidelines in acute stroke care in the setting of general medical wards. In doing so, this project has shown that it is quite feasible to deliver best-practice care to stroke patients in rural Australia.
authors.affiliation: West Gippsland Hospital, Warragul, Victoria, Australia. aa.wright@bigpond.com
authors.forename: A A
authors.initials: AA
authors.lastname: Wright
authors.forename: G
authors.initials: G
authors.lastname: Ranmuthugala
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: B
authors.initials: B
authors.lastname: Maydom
authors.forename: P
authors.initials: P
authors.lastname: Disler
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D019317:Evidence-Based Medicine / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data* / Q000639:trends; D019538:Health Care Surveys; D006780:Hospitals, Rural / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D018570:Risk Assessment; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D014739:Victoria