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External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland.
- Source :
-
Neurologia i neurochirurgia polska [Neurol Neurochir Pol] 2024; Vol. 58 (1), pp. 75-83. Date of Electronic Publication: 2023 Dec 01. - Publication Year :
- 2024
-
Abstract
- Introduction: The Registry of Stroke Care Quality (RES-Q) is used in Poland for quality monitoring by numerous hospitals participating in the Angels Initiative. Our aim was to assess the degree of improvement in highly stroke-oriented centres that report cases to the RES-Q each year.<br />Material and Methods: This retrospective analysis included Polish stroke units that from January 2017 to December 2020 contributed to the RES-Q at least 25 patients annually.<br />Results: Seventeen out of 180 Polish stroke units reported patients each year (2017, n = 1,691; 2018, n = 2,986; 2019, n = 3,750; 2020, n = 3,975). The percentage of ischaemic stroke patients treated with alteplase remained stable (26%, 29%, 30% and 28%, respectively). The door-to-needle time progressively decreased, from a median 49 minutes to 32 minutes. The percentage of patients treated ≤ 60 minutes and ≤ 45 minutes significantly increased (from 68% to 86% and from 43% to 70%, respectively), with no change observed between 2019 and 2020. Despite a general improvement in dysphagia screening (81%, 91%, 98% and 99%), screening performed within the first 24h from admission became less frequent (78%, 76%, 69% and 65%). In-hospital mortality significantly increased (11%, 11%, 13% and 15%), while the proportion of patients discharged home remained stable.<br />Conclusions: Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic.
Details
- Language :
- English
- ISSN :
- 0028-3843
- Volume :
- 58
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Neurologia i neurochirurgia polska
- Publication Type :
- Academic Journal
- Accession number :
- 38037889
- Full Text :
- https://doi.org/10.5603/pjnns.96442