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The two stroke units at the level 3 hospitals adhered most closely to the recommended SA stroke guideline. Elsewhere, ischaemic stroke care varied widely across general medical wards at all hospital levels. Adherence to the guideline was influenced by factors such as limited access to diagnostic investigations, patient delays in receiving medical attention, and shortages of staff. Monitoring systems for continuous evaluation of the quality of acute and post-acute stroke services are needed. The shortfall in compliance with recommended stroke treatment guidelines could lead to worse outcomes and exposure to litigation.
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Mandizvidza et al. (2021) studied this question.