1. Needs Assessment

2. System Development

3. Clinical and Operational Implementation

4. Training

5. Evaluation

Case Study

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Section 4: Telestroke Training

Guidelines suggest that staff providing telestroke services should have an appropriate level of expertise in stroke care and experience of the technical system. All decision-support providers must have training and experience in diagnosing and treating acute cerebrovascular disease. Training should occur at regular intervals. There should be effective clinical and educational collaboration between network participants. 1

Research on potential barriers to the ability of staff to deliver telestroke includes:

Other telestroke projects detail the implementation tasks and resources to: Lessons learned from the case study include:
4.1 Clinical Training for telestroke

Who should do

  1. patient referral assessment?
  2. interpretation of CT scans?
  3. decision-support provider role?
  4. thrombolysis delivery?
  5. post-thrombolysis monitoring?

Who should assess competence for telestroke?

Building confidence and expertise in telestroke

4.2 Wider Training and Updating

Training provision and updating

Cultural issues

  1. between disciplines
  2. raised by audio-visual communication

4.1 Clinical training for telestroke

Staff at the patient referral site will need training in the initial assessment of suspected acute stroke, and in equipment set-up, use, and maintenance of the telestroke equipment; staff undertaking a decision-support provider role need training in remote desktop access to the system and manipulation of the camera. 8, 9  Training in the local environment, and use of simulation might be useful. 10

Implementation task Detail Example
Roles, responsibilities and competencies for telestroke

By role: e.g. telestroke “superuser” (train the trainer role), paramedics, emergency department triage, stroke specialist nurse, emergency department medical staff, on-call radiographer, on-call radiologist, stroke consultant etc.

Roles and Responsibilities policy

For each stage in the patient pathway: pre-hospital, arrival in the emergency department assessment for thrombolysis, CT scanning and interpretation, thrombolysis decision, immediate/ongoing post-thrombolysis care.

Training needs for telestroke

Training strategy and needs analysis

Training Action Plan

Training priorities

Training priorities

Thrombolysis training strategy

Thrombolysis Training Strategy

Training programme objectives

Stroke specialist/decision-support provider

Proposed training for decision support provider

Patient referral site practitioner

Proposed training for hospital medical staff


Proposed training for Nurses

Training resources

Stroke Thrombolysis Awareness

Thrombolysis awareness training day agenda

Thrombolysis and Neuroradiology in Stroke

Thrombolysis Training Day Flyer


Thrombolysis Training Package


DVD to be available shortly

CT Interpretation - Developed by the Cardiac and Stroke Network in Lancashire and Cumbria

link to astracat training

Case studies

Thrombolysis case study

Assessment of competency

Clinical competencies

Clinical competencies

Technical competencies

Technical competencies

Administrative competencies

Administrative  competencies


Lessons learned from the case study:

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4.2 Wider Training and Updating

Continuous education and training is needed. 3, 4 7, 8  Some systems identify “superusers” – people who take responsibility for system training and retraining, and who take a lead in communication. 8  Monitor the turnover of IT staff in participating organisations, and maintain the training of new IT staff in telestroke system support. 3, 4

Implementation task Detail
Training administration Provided by Telestroke Administrator

Training updating

Refresher training is provided by the Telestroke Administrator as necessary according to Site Reports

There are monthly MDT meetings for Consultants that attract CPD points

IT staff training

Provided by Telestroke Administrator as necessary according to site reports

Lessons learned from the case study:

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