13 Years - Learning and Development of Stroke Fast Track in Thailand

Abstract

The National Health Security Office (NHSO) has encouraged the free treatment of patients with acute ischemic stroke with thrombolytic treatment starting in 2008 only at university hospitals in Greater Bangkok. Subsequently, the aforementioned treatment services have been expanded to all areas in Thailand. The challenge of such treatment is that the time from the patient’s neurological symptoms until receiving thrombolytic treatment must be within 270 minutes as soon as possible. A shortage of neurologists in the provinces challenged the development of stroke service network. Using the principles of NETWORK (N: national standard, E: engagement, T: teamwork, W: wisdom, O: organization, R: reach target, K: knowledge management) and STANDARD (S: seamless, T: timeliness, A: awareness, N: network, D: drug available, A: ability, R: referral system, D: district health system) enabled nationwide service expansion in 2011. The current rate for acute ischemic stroke patients with thrombolytic treatment was approximately 8%.