Precision matters: How Stroke Distinction helps move the needle towards better stroke care  

September 18, 2025

When the Stroke Distinction program was first introduced, its goal was to standardize best stroke care practices across the country, act as a tool to leverage that expertise and raise the bar for quality and safety in stroke care. It has done that, and more, say the people who work closely with it, as they strive continuously to refine and reinforce the program to reach even higher levels of quality.

Stroke Distinction was developed in close partnership with the Canadian Stroke Network (now Heart and Stroke Foundation). It follows evidence-based standards and incorporates the nationally recognized Canadian Stroke Best Practice Recommendations.

To date, 27 organizations and 51 sites are participating in the program, both in Canada and abroad. According to experts in the field, two primary reasons explain the program’s success: the key quality indicators that allow care providers to see precisely where they are in providing the best possible stroke care and the extraordinarily valuable work performed by Accreditation Canada surveyors during in-person visits.

Many aspects of stroke care lend themselves to precise measurement. Perhaps the best-known is the one called “door-to-needle” time, as time required to get the patient to their treatment is critical for best outcomes. The idea behind the Distinction program was to include specific quality indicators so each organization could use measurements to achieve safe, high-quality care and monitor these improvements over time.

Kelli O’Brien, interim chief administrative officer for Health PEI and Accreditation Canada surveyor for over two decades, was asked to help test Stroke Distinction in its pilot project phase. As a data-driven health professional, she sees great value in the program’s key quality indicators. “Everyone is asked to measure those, so from a surveyor’s perspective, you can actually watch improvements over time, you can watch how organizations are assessing improvement initiatives and the outcomes they’re seeing in their measurements.”

Trish Helm-Neima, stroke coordinator with Health PEI, explains that the requirement for numbers to be reported and used in assessments and surveys is a crucial part of the process. “It’s really important that what surveyors are seeing when they do their visit is backed up by the data.”

How each organization works to improve its quality indicators is precious information that is shared across all participating sites. Keysha Low, a surveyor who works in the Alberta Health System after

serving in over 20 high-performing hospitals across Canada and the United States, sees value in being able to drill into data with organizations. “Even if they’re just meeting the threshold, we dive deeper into why it is that they’re at 70 percent,” she explains. “And what would it take to get them to 80. What would it take to get to 90. That whole conversation really helps develop those programs in a more robust way because you’re giving tangible feedback on how they can improve their process to meet the metrics that are evidence-based.”

Sometimes improvements can be disarmingly low-tech and simple, such as the Stroke Clock. Something that Hilda Bellows of Newfoundland and Labrador Health Services noticed when surveying an organization in Ontario. With her extensive background as an emergency nurse, she immediately saw the clock’s potential as a big visual tool on the wall, visible to everyone, to keep them informed of the time elapsed since a patient’s arrival and focused on achieving the best possible results for that patient. Bellows smiles when she describes the beautiful clock her team acquired for the department. “It looks good!”

Julianne Cavanagh is clinical operations lead for the stroke and neurology program at St. Michael’s hospital in Toronto, part of Unity Health Toronto, where teams had worked for years on aligning with best practices and making great strides. Participating in Stroke Distinction, she says, “really made us focus on more of the details.” As well, while the earlier focus had been on hyper-acute care and processes, “Stroke Distinction helped us look at the transitions of a patient throughout their stroke care journey, as well as the education components and really bring it all together,” which resulted in stronger relationships between her acute hospital and rehabilitation sites and improved pathways for patients and their families.

Rhonda McNicoll-Whiteman, clinical nurse specialist with the regional stroke program at Hamilton Health Sciences with four cycles of Stroke Distinction under her belt, says the program “really allowed us to focus on the business that we do and where we are at, and how we can improve it.” The process is also a great way to validate her teams’ efforts.

Stroke care professionals get excited to show their progress and their excellent work to peer surveyors during in-person visits, she says. “Obviously our goal is to improve care. And yes, we want to become accredited at the end. But it’s the process and the feedback of what we’re doing well and where we still need to improve that is the real benefit of the program.”

A sentiment echoed by Trish Helm-Neima. “It’s that outside lens that can be used to either reward people for the great work that they’re doing and patting them on the back and saying, look, your work does mean something.”

Julianne Cavanagh’s experience follows a similar pattern, but with a twist. “I thought I knew our program very well and I guess the Stroke Distinction did what it was intended to do and shine light on areas that we had not yet recognized. It did take me by surprise that the surveyors were able to, in the relatively short time that they were here, so clearly understand the details and nuances of our program,” she explains, noting that surveyors recognized all their areas of excellence. But they also shone a light “on areas that I don’t think any of us had really noticed before. It really enabled us to refocus and work on strengthening those areas.”

Progress goes both ways

Since the beginning of the program, Stroke Distinction surveyors have been deliberately chosen for their deep knowledge and expertise in stroke care. And they, too, are committed to continuous improvement. As Keysha Low explains, the feedback surveyors receive from the teams they visit helps them improve the way they do their work. “I think we can’t just talk the talk, we have to walk the walk,” she says. “If I’m asking people to constantly change and constantly be better, then I also expect them to hold me to the same standards.”

Kelli O’Brien, looking back on her 35 years as a health professional, has no hesitation saying that the learning opportunities and connections she had by working as a surveyor were the best professional development of her career. “I just think it’s a real privilege to go into another organization, to have them open up their books to you or their life to you with all honesty, and to really be able to help them see what they already know sometimes. To really validate what they’re seeing and to help them drive that needle towards excellence.”

She is proud of her work, being a strong advocate for quality and safety in the health care system in Canada.

“I love this work and I get joy from this work.”

Any organization or stroke system that is enrolled in our Qmentum Global™ program and provides a structured stroke care program can participate in the Stroke Distinction™ program. Connect with an advisor today to discuss how it can benefit your organization.

Interested in applying your deep knowledge and expertise in stroke care? Click for more information on the surveyor recruitment process and current opportunities.