National Stroke Audit Rehabilitation Services 2016 Key data and messages The National Stroke Audit Rehabilitation Services Report 2016 provides the largest snapshot to date of the processes of care within rehabilitation services for stroke in Australia. The report highlights areas where the system is working well and reports on improvements or changes that may be needed

The National Stroke Audit Rehabilitation Services (2016) comprises two elements.. An Organisational Survey of stroke rehabilitation services across Australia. A retrospective Clinical Audit stroke rehabilitation patient case notes. Examining the resources, processes and infrastructure in place to support best practice stroke care Enables reporting against each required element outlined in the Stroke Rehabilitation Services Framework (2013) Examines processes of care as outlined and recommended in the Clinical Guidelines Hospitals reviewed case notes for up to 40 consecutive episodes admitted and discharged between 1 January and 31 December 2015

Maximising use of your hospital’s National Stroke Audit 2016 results.. Share a clear picture of both the process of care and organisational issues that impact on stroke service delivery to other team members. Benchmark the quality of stroke care in your hospital against other hospitals that manage similar numbers of stroke admissions. Identify potential strengths and weaknesses in the management of stroke and highlight focus areas for ongoing quality improvement activities. The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

Populating your hospital’s slide-deck template.. Your slide-deck should be used to share and present your site’s National Stroke Audit data to the rest of your team and any interested stakeholders. The template is intended to be interactive, please add or remove slides to suit your hospital’s individual requirements. To populate, refer to your hospital’s site report (or summary) and the National Stroke Audit Rehabilitation Services Report 2016. The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

Register now: informme.org.au/sign-up Using InformMe.. Bringing together a range of resources to support health professionals in delivering the best quality stroke care, this new online tool allows allow hospital staff to easily access.. Interactive graphs plotting your site’s National Stroke Audit data against national and volume-specific averages. National and site-specific reports from current and previous National Stroke Audit cycles. Support in creating your quality improvement plans in response to your local National Stroke Audit data, plus the opportunity to view plans that other hospitals have submitted. The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation. Register now: informme.org.au/sign-up

Where to find your Organisational Survey data.. Step 1. Download your site report: informme.org.au/stroke-data Step 2. Select Tab E along the bottom of your screen The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation. Your site’s results are in column C Find aggregated data for service’s of a similar size to yours in columns E-G

Where to find your Clinical Audit data.. Step 1. Download your site report: informme.org.au/stroke-data Step 2. Select Tab B along the bottom of your screen The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation. Your site’s results are in column B Find aggregated data for service’s of a similar size to yours in columns K-M

National Stroke Audit Rehabilitation Services 2016 Organisational Survey Assessing the resources required to deliver evidence-based stroke care. The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

Adherence to the Framework Median number of elements met Plot your hospital’s results by positioning the dotted line along the X-axis.. Australia (N=121) >80 stroke admissions per annum (N=41) 30-79 stroke admissions per annum (N=58) <30 stroke admissions per annum (N=41)

Organisational Survey Framework Element of service Australia n (%) My site Yes/No Similar service n (%) Systems for transfer of care, follow-up and re-entry for patients 35 (29%) Support for the person with stroke and carer to maximise community participation and long-term recovery 61 (50%) Systems that support quality improvement, i.e. regular review of local audit data by the stroke team to prioritise and drive stroke care improvement 91 (75%) The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

Organisational Survey Framework Element of service Australia n (%) My site Yes/No Peer hospitals n (%) Standardised and early assessment for neuro- rehabilitation 69 (57%) Written rehabilitation goal setting processes with patients 89 (74%) Routine use of evidence-based guidelines to inform evidence-based therapy for clinicians 68 (56%) Best practice and evidence-based intensity of therapy for goal related activity with patients 62 (51%) The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

Organisational Survey Framework Element of service Australia n (%) My site Yes/No Similar service n (%) Effective links with acute stroke service providers 80 (66%) Specialised interdisciplinary stroke (or neuro-rehabilitation) team with access to staff education and professional development specific to stroke 74 (61%) Co-located stroke beds within a geographically defined unit 12 (10%) The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

National Stroke Audit Rehabilitation Services 2016 Clinical Audit Measuring delivery of care as outlined in the Clinical Guidelines for Stroke Management (2010) Turning now to the second component of the National Stroke Audit. A retrospective case note audit. These data are based on over 3,500 stroke rehabilitation admissions in 2015. Clinical Audit measures the delivery of processes of care against evidence-based recommendations from the Clinical Guidelines. All stroke rehabilitation services should demonstrate significant levels of compliance with these guidelines, but instead this year’s Clinical Audit broadly shows a deterioration in the delivery of recommended best-practice.

Clinical Audit Patient centred care Australia n (%) My site n (%) Similar service Goals set with input from team and patient 2961 (89%) Patient's mood assessed during admission 1866 (53%) The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

Clinical Audit Discharge planning Australia n (%) My site n (%) Similar service Patient and/or family received information covering stroke, hospital management, secondary prevention and recovery (e.g. My Stroke Journey booklet) 1769 (50%) Carer received relevant training 820 (75%) Evidence that care plan was developed with the team and patient (or family alone if patient has severe or cognitive impairments) 2535 (78%) The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

Clinical Audit Secondary prevention Australia n (%) My site n (%) Similar service Patient received education about behaviour change for modifiable risk factors prior to discharge 1790 (51%) Patient prescribed antihypertensive medication on discharge 2651 (78%) The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

Recommendations from the National Stroke Audit Rehabilitation Services 2016 Greater adherence to essential elements outlined in the Framework, particularly ensuring all stroke patients are managed on one dedicated ward. Greater focus on processes to ensure that the psychological and emotional needs of all stroke survivors are assessed and appropriate support is provided during and after inpatient rehabilitation. Further efforts to ensure all stroke survivors, plus family/carers, are involved in their rehabilitation. This includes the provision of information, collaborative goal-setting, and thorough education on stroke recovery, risk factor modification and the importance of secondary medication compliance. Ensure secondary prevention medication is initiated prior to discharge. Continued efforts to provide comprehensive discharge planning to all stroke patients, including personalised care plans as well as specific training and support for carers. Increased focus on routine adherence to evidence-based guidelines and reducing unwanted clinical variation by developing improved systems of care. The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

National Stroke Audit 2016 Local implications and discussion points The National Stroke Audit is made up of two components. Firstly, a survey of stroke rehabilitation services across Australia – this assesses the resources required to deliver evidence-based stroke care. The questions reflect the Stroke Rehabilitation Services Framework – which outlines principles, essential elements and resources needed to deliver best practice stroke rehabilitation.

National Stroke Audit 2016 Where to find out more Download the report at: While I have touched upon the key findings from this year’s National Stroke Audit, the full National Report contains far more. From today, it is available to download from InformMe – the Stroke Foundation’s new website aimed at supporting health professionals in delivering quality stroke care. FINISH. informme.org.au/stroke-data