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Original Research

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Reorganisation of stroke care in prehospital emergency medical services: results through transformative learning

  • Lauri Antila1
  • Anne Jyrkiäinen2
  • Lasse Hakala1,3
  • Seppo Uusinarkaus1,3
  • Juhani Tavasti1
  • Ari Palomäki1,4

1Department of Emergency Medicine, Kanta-Häme Central Hospital, Ahvenistontie 20, FI-13530 Hämeenlinna, Finland

2Faculty of Education and Culture, Tampere University, FI-33014 University of Tampere, Finland

3Emergency Medical Services of Kanta-Häme, Kutalantie 1 B, FI-13210 Hämeenlinna, Finland

4Faculty of Medicine and Health Technology, Tampere University, FI-33014 Tampere University, Finland

DOI: 10.22514/sv.2021.054

Online publish date: 31 March 2021

*Corresponding Author(s): Lauri Antila E-mail:


Background: Rapid recanalisation is important when treating ischaemic stroke patients. In Finland, the reorganisation of the prehospital emergency medical system and the establishment of emergency medicine as an independent speciality occurred some years ago. These reforms offered the opportunity to develop new prehospital and in-hospital pathways for stroke patients.

Methods: In this retrospective study, we examined the immediate impact of implementing a new operating model in prehospital stroke care. We introduced a modified “load-and-go” model using a transformative learning process. We observed the immediate effects of the reorganisation by comparing prehospital time intervals three months before and three months after the reorganisation.

Results: The new operating model was implemented using a transformative learning process. There was an immediate reduction of 35.1% from 21.4 to 13.9 minutes (P < 0.001) in the median on-scene time and of 18.2% from 52.7 to 43.1 minutes (P < 0.05) in the median total time, i.e. the time interval between the alarm from the dispatch centre to patient hand-over to ED.

Conclusion: By using a transformative learning process in implementing a modified load-and-go operation model in the EMS, we could immediately reduce median on-scene time and median total time in the treatment of acute stroke patients.


Acute ischaemic stroke; Emergency medicine; Thrombolysis; Reorganisation; Prehos-pital emergency medical system

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Lauri Antila,Anne Jyrkiäinen,Lasse Hakala,Seppo Uusinarkaus,Juhani Tavasti,Ari Palomäki. Reorganisation of stroke care in prehospital emergency medical services: results through transformative learning. Signa Vitae. 2021.doi:10.22514/sv.2021.054.


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