Stroke is a common neurological condition and the most common cause of disability among adults in Singapore. Optimal outcomes are dependent not only on facilities and skilled staff, but on a multidisciplinary approach for its management. The dedicated multidisciplinary team at NUH includes neurologists, interventional neuroradiologists, emergency physicians, neurosurgeons, radiologists, rehabilitation physicians, anesthetists, nurses, physiotherapists, occupational therapists, speech therapists, medical social workers, pharmacists, care coordinators, case managers and stroke nurse educators.
The stroke team has at its core neurologists dedicated to stroke care. It manages more than a thousand ischemic stroke patients annually. Working seamlessly with interventional neuroradiologists, emergency physicians, neurosurgeons and radiologists, they introduced HASTEN (HyperAcute Stroke & Endovascular Team), the Thrombolytic Therapy Programme and Endovascular treatment, to give acute ischemic stroke patients the best chance of reperfusion therapy. The team leader pioneered Early Supported Discharge (ESD) in 2007 which extends care and rehabilitation into the community.
The Stroke team ensures the application of best evidence medicine to achieve optimum outcomes. Figures 1 and 2 below shows the improvement in stroke outcome from 2014 onwards.
Chart 1. Average Length Of Stay (days).
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Chart 2. Readmission Rates and Mortality Rates (%).
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Chart 3. Thrombolysis Door to Needle Time (min).
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The chart shows how quickly stroke patients receive clot busting treatment over time, using a key measure called “door to needle” time—the time from arrival in the Emergency Department to treatment. Since 2014, the median treatment time has improved from 77 minutes to about 48 minutes in 2025, meaning patients are receiving care more quickly. Over the same period, the proportion of patients treated within the target of 60 minutes has increased substantially from 18.7% to around 72%, reflecting steady progress in delivering timely, effective stroke treatment.
