The scope for improvement in hyper-acute stroke care in Scotland

We model the system as a discrete-event simulation following the patient journey, starting when patients have a stroke and ending at thrombolysis for those who qualify. The simulation results show that just improving the performance of all hospitals to the level of the best performing hospital would (even without improvements in onset to arrival times) increase the thrombolysis rate from 6% (in 2010) to 11% of all admitted stroke patients in Scotland. By 2013 9% of patients were receiving thrombolysis, suggesting there is still room for improvement.