Regional Stroke Centres

Within Toronto there are 3 Regional Stroke Centres:

St. Michael’s Hospital (SMH)
A Regional Stroke Centre within the South East Toronto stroke region.
30 Bond St, 14th floor Cardinal Carter Wing
Toronto, Ontario, M5B 1W8

Sunnybrook Health Sciences Centre (SHSC)
A Regional Stroke Centre within the North & East GTA stroke region.
2075 Bayview Avenue
5th Floor, D Wing, Room D5-81
Toronto, Ontario, M4N 3M5

Toronto Western Hospital (TWH)
A Regional Stroke Centre within the Toronto West stroke region.
399 Bathurst Street
5th Floor, West Wing, Room 425
Toronto, Ontario, M5T 2S8

By working closely with Toronto Paramedic Services suspected stroke patients can access Regional Stroke Centres directly via ambulance by bypassing non-regional stroke centres.

These 3 regional centres offer pre-hospital, emergency, acute, and secondary prevention services.

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Emergency Stroke Management

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To ensure access to stroke best practices, Ontario paramedics and hospitals have worked together to bring persons with stroke symptoms directly to the Regional Stroke Centres.  These centres can deliver a clot-busting drug, tissue plasminogen activa (tPA), within 4.5 hours of stroke onset, when indicated.  In Toronto, these Regional Stroke Centres are:  Sunnybrook Health Sciences Centre, St. Michael’s Hospital and Toronto Western Hospital.

tPA is a protein involved in the breakdown of blood clots and has been widely used as a clot-busting drug for ischemic stroke patients. As tPA is not useful for hemorrhagic stroke patients or head trauma patients, paramedics have been trained to recognize the signs and symptoms of stroke, as well as screen for those who benefit from tPA.

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Acute Stroke Unit

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What are the benefits of acute stroke unit care?

• Improved patient outcomes by reducing mortality and disability.
• More timely intervention to get patients moving and begin early rehabilitation (in acute and transferred to rehabilitation centres earlier).
• Specialized assessment skills and training to facilitate improved stroke recovery.

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Acute stroke units in Toronto that are meeting the provincial stroke unit definition* (as reported in the Toronto Stroke Networks’ Standards of Care 2019-2020) include:

• North York General Hosptial 
• Birchmount Hospital – Scarborough Health Network
• Sunnybrook Health Sciences Centre
• Toronto Western Hospital – University Health Network

*Provincial stroke unit definition: A geographical unit with identifiable co-located beds (e.g., 5A-7, 5A-8, 5A-9, 5A-10, 5A-11) that are occupied by stroke patients 75% of the time and has a dedicated interprofessional team with expertise in stroke care with the following professionals at a minimum: nursing, physiotherapy, occupational therapy, and speech-language pathology (Quality-Based Procedures: Clinical Handbook for Stroke (Acute and Postacute), 2016).

These acute stroke units include the following:

• A dedicated interprofessional team with stroke expertise in clinical nutrition, medicine (neurology and general internal medicine), nursing, occupational therapy, pharmacy, physiotherapy, social work, and speech-language pathology.
• Early assessment and initiation of therapy.
• Timely transfer to rehabilitation as appropriate.
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