Article: External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland.
Neurologia i neurochirurgia polska
2023 Volume 58, Issue 1, Page(s) 75–83
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 ... ...
| 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. 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. 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. 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. |
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| MeSH term(s) | Humans ; Stroke/therapy ; Stroke/diagnosis ; Fibrinolytic Agents ; Poland ; Brain Ischemia/drug therapy ; Retrospective Studies ; Deglutition Disorders ; Pandemics ; Quality of Health Care ; Registries ; Thrombolytic Therapy |
| Chemical Substances | Fibrinolytic Agents |
| Language | English |
| Publishing date | 2023-12-01 |
| Publishing country | Poland |
| Document type | Journal Article |
| ZDB-ID | 415519-1 |
| ISSN | 1897-4260 ; 0028-3843 |
| ISSN (online) | 1897-4260 |
| ISSN | 0028-3843 |
| DOI | 10.5603/pjnns.96442 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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