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Stroke in adults [QS2]

Measuring the use of this guidance

Statement: 1

Adults presenting at an accident and emergency (A&E) department with suspected stroke are admitted to a specialist acute stroke unit within 4 hours of arrival. [2010, updated 2016]

Quality standard measure: Proportion of A&E department presentations of suspected stroke in adults in which the person is admitted to a specialist acute stroke unit within 4 hours of arrival.
What was measured: The proportion of patients directly admitted to a stroke unit within 4 hours of clock start.
Data collection end: March 2016
58.3%
Data collection end: March 2017
57.4%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Statement: 2

Adults having stroke rehabilitation in hospital or in the community are offered at least 45 minutes of each relevant therapy for a minimum of 5 days a week. [2010, updated 2016]

Quality standard measure: Proportion of adults having stroke rehabilitation in hospital who receive at least 45 minutes of each relevant therapy for a minimum of 5 days a week.
What was measured: The proportion of patients who receive at least 45 minutes of Occupational therapy, at least 5 days a week.
Data collection end: March 2014
54.9%
Data collection end: March 2017
83.8%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Proportion of adults having stroke rehabilitation in hospital who receive at least 45 minutes of each relevant therapy for a minimum of 5 days a week.
What was measured: Compliance (%) against the therapy target of an average of 25.7 minutes of occupational therapy across all patients (Target = 45 minutes x (5/7) x 0.8 which is 45 minutes of occupational therapy x 5 out of 7 days per week x 80% of patients).
Data collection end: March 2015
72.1%
Data collection end: March 2016
79.6%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Proportion of adults having stroke rehabilitation in hospital who receive at least 45 minutes of each relevant therapy for a minimum of 5 days a week.
What was measured: The proportion of patients who receive at least 45 minutes of Physiotherapy, at least 5 days a week.
Data collection end: March 2014
54.4%
Data collection end: March 2017
79.5%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Proportion of adults having stroke rehabilitation in hospital who receive at least 45 minutes of each relevant therapy for a minimum of 5 days a week.
What was measured: Compliance (%) against the therapy target of an average of 25.7 minutes of physiotherapy across all patients (Target = 45 minutes x (5/7) x 0.8 which is 45 minutes of physiotherapy x 5 out of 7 days per week x 80% of patients).
Data collection end: March 2015
68.7%
Data collection end: March 2016
73.5%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Proportion of adults having stroke rehabilitation in hospital who receive at least 45 minutes of each relevant therapy for a minimum of 5 days a week.
What was measured: The proportion of patients who receive at least 45 minutes of Speech and language therapy, at least 5 days a week.
Data collection end: March 2014
25.2%
Data collection end: March 2017
49.2%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Proportion of adults having stroke rehabilitation in hospital who receive at least 45 minutes of each relevant therapy for a minimum of 5 days a week.
What was measured: Compliance (%) against the therapy target of an average of 25.7 minutes of speech and language therapy across all patients (Target = 45 minutes x (5/7) x 0.8 which is 45 minutes of speech and language therapy x 5 out of 7 days per week x 80% of patients).
Data collection end: March 2015
35.6%
Data collection end: March 2016
41.6%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Statement: 3

Adults who have had a stroke have access to a clinical psychologist with expertise in stroke rehabilitation who is part of the core multidisciplinary stroke rehabilitation team. [new 2016]

Quality standard measure: Evidence of local arrangements and protocols to ensure that services providing stroke care have a core multidisciplinary stroke rehabilitation team that includes a clinical psychologist with expertise in stroke rehabilitation.
What was measured: Proportion of sites that routinely treat patients within 7 days of stroke which report the presence of at least one whole time equivalent qualified clinical psychologist per 30 stroke beds.
Data collection end: July 2016
6%
Number that met the criteria: 10 / 178
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Evidence of local arrangements and protocols to ensure that services providing stroke care have a core multidisciplinary stroke rehabilitation team that includes a clinical psychologist with expertise in stroke rehabilitation.
What was measured: Proportion of sites that routinely treat patients within 7 days of stroke which report the presence of at least one qualified clinical psychologist.
Data collection end: July 2016
57%
Number that met the criteria: 101 / 178
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Evidence of local arrangements and protocols to ensure that services providing stroke care have a core multidisciplinary stroke rehabilitation team that includes a clinical psychologist with expertise in stroke rehabilitation.
What was measured: Evidence of local arrangements and protocols to ensure that services providing stroke care have a core multidisciplinary stroke rehabilitation team that includes a clinical psychologist with expertise in stroke rehabilitation.
Data collection end: July 2014
54%
Number that met the criteria: 98 / 183
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Evidence of local arrangements and protocols to ensure that services providing stroke care have a core multidisciplinary stroke rehabilitation team that includes a clinical psychologist with expertise in stroke rehabilitation.
What was measured: The proportion of days in hospital on which psychology is received for patients who require it.
Data collection end: March 2017
10.2%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Statement: 4

Adults who have had a stroke are offered early supported discharge if the core multidisciplinary stroke team assess that it is suitable for them. [new 2016]

Quality standard measure: Proportion of adults who have had stroke who are treated by an early supported discharge team.
What was measured: Proportion of patients treated by a stroke skilled Early Supported Discharge team.
Data collection end: March 2014
24.7%
Data collection end: March 2015
28.2%
Data collection end: March 2016
32.9%
Data collection end: March 2017
34.6%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

Quality standard measure: Evidence of local arrangements and written clinical protocols to ensure that adults who have had a stroke are offered early supported discharge if the core multidisciplinary stroke team assess that it is suitable for them.
What was measured: Proportion of sites that routinely treat patients within 7 days of stroke which have access to at least one specialist early supported discharge (ESD) team.
Data collection end: July 2014
74%
Number that met the criteria: 135 / 183
Data collection end: July 2016
81%
Number that met the criteria: 145 / 178
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Statement: 6

Adults who have had a stroke have their rehabilitation goals reviewed at regular intervals. [2010, updated 2016]

Quality standard measure: Proportion of adults who have had a stroke who have their rehabilitation goals agreed within 5 days of arrival at A&E.
What was measured: Proportion of applicable patients who have rehabilitation goals agreed within 5 days of clock start.
Data collection end: March 2014
79.7%
Data collection end: March 2015
86.7%
Data collection end: March 2016
89.3%
Data collection end: March 2017
92.5%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Statement: 7

Adults who have had a stroke have a structured health and social care review at 6 months and 1 year after the stroke, and then annually. [new 2016]

Quality standard measure: Proportion of adults who have had a stroke who have a structured health and social care review at 6 months after the stroke.
What was measured: The proportion of applicable stroke patients who had a six month follow-up completed.
Data collection end: March 2016
29.9%
Number that met the criteria: 17402 / 58246
Data collection end: March 2017
32.2%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.



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