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Stroke Quality Improvement Partnership (SQIP)

Improving stroke care in NSW

The ACI Stroke and Rehabilitation Networks are commencing a stroke quality improvement partnership to implement evidence based quality improvement projects in stroke care. The aim of the project is to improve patient outcomes, reduce unwarranted variation in clinical practice, improve consistency of care, and close the gap between theory and practice.

Why is the partnership important?

  • There is variation in the clinical care of stroke patients across their care journey. There is variation between recommended clinical standards and their translation into practice,
  • There are examples of excellent practice across NSW that could be shared to spread improvements

Impact on patient care

  • Care is evidence based and adheres to clinical standards and guidelines
  • Consistency in treatment improves.
  • Improved adherence to the ACSQHC Acute Stroke Clinical Care Standards in access to treatment and specialist stroke unit care
  • Improved adherence to Stroke Foundation Rehabilitation Stroke Services Framework

Primary Target Areas for the Collaborative (Acute and Rehabilitation)

  1. Increase the proportion of stroke patients receiving thrombolysis
  2. Reduce the door to needle time
  3. Increase the numbers of patients that access a stroke unit
  4. Improve discharge medication provision
  5. Optimise access to rehabilitation
  6. Improve discharge planning and provision of written care plans
  7. Improve provision of risk factor modification information provided to patient/ carers/family
  8. Improve the education and information provided to patients and carers prior to discharge
  9. Improve screening and management of continence
  10. Improve screening and management of mood

NSW Impact Measures

  1. Aim to increase the number of ischaemic stroke patients receiving thrombolysis from 11% (2015: 8%)
  2. Aim to reduce the door to needle time and increase the proportion of patients receiving thrombolysis within 60min from 29% (2015: 17%)
  3. Aim to increase the number of patients that access a stroke unit from 67% (2015: 41%)
  4. Aim to increase the number of patients discharged on appropriate medications from 65% (2015: 63%)
  5. Aim to increase the number of patients with a documented assessment for rehabilitation 53% (2015: 60%)
  6. Aim to increase the number of patients provided with a written care plan from 73% (2015: 56%)
  7. *Aim to increase the number of patients that are provided individualised risk factor modification advice 48% (Acute 2017 76%)
  8. *Aim to increase the proportion of patients/carers that are provided with information and education, care plan to maximise community participation from 48% (Acute 2017 58%)
  9. *Aim to increase the number of patients with  a documented continence assessment and management plan from 36% (Acute 2017 24%)
  10. *Aim to increase the number of patients with a documented mood screening and management plan from 47% (Acute 2017 27%)

Acute: Data from NSW Stroke Foundation acute audit 2017 & 2015 state averages

Rehabilitation: * Data from 2016 Stroke Foundation rehabilitation audit, reviewed and prioritised by the Stroke Rehabilitation and Recovery Working Party