St. Thomas Elgin General Hospital
189 Elm Street
St. Thomas, Ontario N5R 5C4
District Stroke Coordinator:
Sandra Pincombe, BSN, RN, 519-631-2030 ext. 2417, firstname.lastname@example.org
Elgin-Oxford-west Norfolk is the newest stroke district in the South West Local Health Integration Network (LHIN). It is located at the far southern border of the LHIN, tracing the shoreline of Lake Erie. It is comprised of Elgin County, the southern portion of Oxford County (south of the 401 and 403 highways), and the western third of Norfolk County. This rural district is home to the small city of St. Thomas, the district’s population centre, several small towns, and numerous hamlets. According to 2016 census data:
- The population of Elgin County is 88, 987
- The population Oxford County within the district is approximately 34, 537
- The population of Norfolk County within the district is approximately 12, 609
- This creates a total district population of approximately 136, 124
Currently, St. Thomas Elgin General Hospital (STEGH) does not provide the clot-busting drug, tPA. London Health Sciences Centre – University Hospital (UH) will continue to assess and provide this drug to residents of Elgin and Oxford Counties. Residents of Norfolk County will continue to be taken to Brantford Community Healthcare System – Brantford General Hospital (BGH) for this care. The ambulance will take individuals within 4.5 hours of stroke symptom onset to one of these two facilities for assessment. Those presenting in person to STEGH or Tillsonburg District Memorial Hospital (TDMH) within this time window will be urgently transferred to UH.
STEGH provides hyperacute care for stroke patients outside of the 4.5-hour window for tPA, and for those with high-risk transient ischemic attack (TIA). STEGH has specialized diagnostic equipment and physicians with advanced knowledge of stroke who will assess the TIA/stroke patient and begin medical treatment to stabilize and help reduce the impact of stroke, or redice the risk of stroke onset for those experiencing TIA. The ambulance will bypass patients with symptoms of stroke outside of the 4.5-hour window to STEGH for a specialized assessment. Those arriving in person to TDMH outside the 4.5 hour tPA window will be rapidly transferred to STEGH.
Individuals initially transported to LHSC will be repatriated to STEGH for the duration of their care.
STEGH has an eight-bed integrated stroke unit (ISU). On an ISU, inpatient acute and rehabilitation beds are clustered together and served by a consistent, interprofessional team with expertise in stroke care, which supports continuity of care. The interprofessional team consists of physicians, nursing, physiotherapy, occupational therapy, speech-language pathology, physiotherapy/occupational therapy assistant, social work, pharmacy, dietitian, and recreation therapy.
STEGH offers specialized stroke prevention services through its secondary stroke prevention clinic for residents of the district. The secondary stroke prevention clinic provides rapid, specialized assessment and creation of a medical management plan by a nurse and physician with stroke expertise for individuals with stroke and/or TIA. A consultation note is the shared with the primary care provider in a timely way.
Community-based rehabilitation services for the district are provided by the Thames Valley Community Stroke Rehabilitation Team (CSRT), which is based out of Parkwood Institute. A strong system of open communication exists between the STEGH therapists and the CSRT Program Assistant to support timely CSRT referrals. The Community Care Access Centre (CCAC) provides personal support worker services as well as interim allied health care.
A Stroke-Specific Adult Day Program is offered weekly at Terrace Lodge in Aylmer. Run by the County of Elgin, and supported by the CSRT, this specialized and goal-focused adult day program assists the ongoing recovery of individuals who have completed the active phase of rehabilitation. It provides therapy-guided exercise and education, and serves as a transitional program to re-engagement in the community.