http://stroke.ahajournals.org/content/early/2015/08/11/STROKEAHA.115.008811.abstract?sid=be9cbfe0-ac87-4d08-899e-ede87e9d54aa
- Bo Norrving, MD, PhD,
- Benjamin D. Bray, MD,
- Kjell Asplund, MD,
- Peter Heuschmann, MD, MPH,
- Peter Langhorne, PhD,
- Anthony G. Rudd, MD,
- Markus Wagner, PhD,
- Silke Wiedmann, PhD,
- Charles D.A. Wolfe, MD,
- for the European Implementation Score Collaboration
+ Author Affiliations
- Correspondence to Benjamin D. Bray, MD, PhD, Division of Health and Social Care Research, Capital House, 42 Weston St, London SE1 3QD, United Kingdom. E-mail benjamin.bray@kcl.ac.uk
Abstract
Background and Purpose—There
are no agreed measures of stroke care quality that enable the
standardized comparison of stroke care between countries.
We aimed to develop a set of measures of
quality of acute stroke care involving stroke quality registers in
Western Europe.
Methods—A
multinational working group identified 6 regional or national stroke
quality registers in Europe and reviewed their data
sets, performance measures, and the method by
which these had been developed. Measures used in the registers were
presented
for discussion to a consensus group of
representatives from the quality registers identified, as well as other
stroke experts,
and the final set of common performance
measures was agreed through majority consensus.
Results—Thirty
final performance measures were agreed by the European consensus group,
encompassing the domains of coordination of
care (stroke unit–based care), diagnosis
(brain imaging, vascular imaging, cardiac arrhythmia detection, and
therapy assessment),
preservation of neural tissue (thrombolytic
therapy and door-to-needle time), prevention of complications (dysphagia
screening),
initiation of secondary prevention
(antiplatelet, anticoagulation, lipid lowering, blood pressure lowering,
carotid surgery,
time from vascular imaging to carotid
surgery, and smoking cessation), survival (90-day poststroke mortality),
and functional
outcomes (90-day modified Rankin Scale).
Conclusions—On the basis of experience of quality registers in Europe, we have proposed a common set of performance measures that will
facilitate the international comparison of acute stroke care quality.
No comments:
Post a Comment