Achievements against Priority Initiatives
FAST-CT project team, RNSH
ROYAL NORTH SHORE HOSPITAL FAST-CT Stroke Pathway: Saving Time, Preserving Brain Function
At Royal North Shore Hospital, a new approach to stroke care is transforming treatment pathways and improving patient outcomes. The FAST-CT model— Facilitating Accelerated Stroke Transfers to Computed Tomography (CT) — was implemented in the Emergency Department to address delays in diagnosing and treating acute stroke patients, which can lead to irreversible brain damage and prolonged recovery. The FAST-CT pathway enables eligible stroke patients arriving by ambulance to bypass traditional triage and proceed directly to CT imaging while remaining on the ambulance stretcher. This streamlined approach ensures rapid access to thrombolysis and neuro-intervention, preserving critical brain function. The results have been remarkable: • Door-to-CT time reduced from 27 to 15 minutes • Door-to-needle time for thrombolysis reduced from 57 to 32 minutes • Hospital length of stay shortened from 5 to 4 days • No critical incidents reported , suggesting that patient safety is not compromised with this approach. • Patient selection was highly accurate , with only one stroke mimic identified among 120 cases— demonstrating the pathway’s strong ability to distinguish true strokes from similar presentations.
These improvements mean more patients regain speech, mobility, and independence—outcomes that profoundly impact quality of life. The pathway is now embedded in daily practice and has been successfully replicated at Hornsby Ku-ring-gai Hospital. The project exemplifies safe, high-quality, and reliable healthcare delivered in a personalised way, tailored to the urgency and needs of each patient. It reflects the power of collaboration across Emergency, Neurology, Radiology, and NSW Ambulance teams, and highlights how innovation can drive better care without requiring additional resources.
WINNER
In recognition of its impact, the FAST-CT project won the 2025 NSLHD Quality and Improvement Award for Patient Safety First. A video showcasing the project can be viewed here: https://vimeo.com/1096123907
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