Introduction
Stroke, stroke, ischemic stroke, Stroke-related, acute stroke
STROKE, TRANSIENT ISCHEMIC ATTACK, STROKE, BEST, ISCHEMIC STROKE, ACUTE STROKE
Stroke-related mortality in Canada during the 10-year period 2003–2013 decreased by 26.1% (38.0 to 28.1 per 1,000), consistent with the decline in stroke incidence of 21.6% which is observed from 2003–2011 in Ontario, Canada’s most populated province [Mobile Stroke Units (MSUs) are rapidly expanding on a global scale, having been implemented in 23 locations in the US as well as countries such as Germany, Australia, Norway, India, Argentina, Thailand, and Canada. MSUs provide rapid access to diagnostic and treatment services via a specialized ambulance equipped with CT scanner, stroke-specific medications, point-of-care laboratory testing, and other supplies and capabilities needed to treat ischemic stroke patients.Australia’s national system of clinical audits to ensure that evidence-based acute stroke care aligns with best practices has resulted in a range of improvements over the period 1999 to 2019 in areas including rapid assessment/management for patients with transient ischemic attack, access to stroke units, receipt of thrombolysis services, risk factor advice, and carer training [Alongside these improvements in the organization and provision of acute stroke care services has been relatively short hospital length of stays in most developed countries, thus most of the stroke patients’ recovery occurs after the patient is discharged from the hospital [TC includes a broad spectrum of services that are often included in the same category as ESD for post-acute care of stroke [The existing evidence of the effectiveness of TC services for stroke patients is mixed. Jee et al.’s [ESD and TC services typically last a maximum of 3 months, after which patients requiring further rehabilitation are transferred to other community services [Nevertheless, there have been continued efforts to develop and implement clinical guidelines on stroke rehabilitation that emphasize services to support transitions as patients move from one stage to another in their stroke recovery. One example is Part Two of the Canadian Stroke Best Practice Recommendations, which focuses entirely on transitions with recommendations on: 1) Ultimately, the burden of stroke in Canada is expected to rise due to an increase in the number of people experiencing and/or surviving a stroke, which is a consequence of various forces including population growth, aging, and improvements in acute stroke care [Studies from other countries similarly report that stroke survivors are unable to access essential rehabilitation services following hospital discharge [Virtual stroke rehabilitation services (also called telemedicine, telehealth, or telerehabilitation) have been introduced to help address service gaps/access issues. Before the COVID-19 pandemic these services were not widely used; however, the pandemic propelled their rapid expansion in Canada and across the globe to address abrupt interruptions in clinical services [Consideration of telehealth as a replacement for in-person services needs to ensure that certain groups are not disadvantaged. Studies have reported that telehealth services are less likely to be used by certain ethnic groups, rural residents, men, and older adults [Current Canadian best practice guidelines for managing care transitions following stroke are largely built upon evidence from observational or qualitative studies, or expert consensus [