2. SINAP Results First Quarterly Public Report July 2010 – June 2011 admissions An interactive slideshow allowing you to click on links to take you to the key indicators that you want to see. For example, you can click on a key indicator link on the next page to take you to its description. Then you can click on “Graph” to see a graph of national figures for that indicator.

3. Contents Annual data Quarterly data Box plots Key Indicator 1 Key Indicator 2 Key Indicator 3 Key Indicator 4 Key Indicator 5 Key Indicator 6 Key Indicator 7 Key Indicator 8 Key Indicator 9 Key Indicator 10 Key Indicator 11 Key Indicator 12 Average of 12 KIs Feedback Contents Page last viewed End Number of patients

4. Key Indicator 1Key Indicator 2Key Indicator 3Key Indicator 4Key Indicator 5Key Indicator 6 Number of patients scanned within 1 hour of arrival at hospital Number of patients scanned within 24 hours of arrival at hospital Number of patients who arrived on stroke bed within 4 hours of hospital arrival (when hospital arrival was out of hours) Number of patients seen by stroke consultant or associate specialist within 24h Number of patients with a known time of onset for stroke symptoms Number of patients for whom their prognosis/diagnosis was discussed with relative/carer within 72h where applicable 5149 (29%)15944 (91%)4511 (47%)14520 (75%)10064 (52%)15310 (85%) Annual data July 2010 – June 2011 The above table shows key indicators 1-6 across all hospitals, with the number (and percentage) of patients who received each standard. Contents Page last viewed End Next part of table

5. Key Indicator 7Key Indicator 8Key Indicator 9Key Indicator 10Key Indicator 11Key Indicator 12 Average Number of patients who had continence plan drawn up within 72h where applicable Number of potentially eligible patients thrombolysed Bundle 1: Seen by nurse and one therapist within 24h and all relevant therapists within 72h (proxy for NICE QS 5) Bundle 2: Nutrition screening and formal swallow assessment within 72 hours where appropriate Bundle 3: Patient's first ward of admission was stroke unit and they arrived there within four hours of hospital arrival Bundle 4: Patient given antiplatelet within 72h where appropriate and had adequate fluid and nutrition in all 24h periods Average of 12 key indicators 4221 (57%)1050 (49%)7905 (48%)14161 (82%)8917 (48%)9257 (56%)60 Annual data July 2010 – June 2011 The above table shows key indicators 7-12 across all hospitals, with the number (and percentage) of patients who received each standard. It also shows the average of the 12 key indicators. Contents Page last viewed End Previous part of table

6. Key Indicator 1Key Indicator 2Key Indicator 3Key Indicator 4Key Indicator 5Key Indicator 6 Number of patients scanned within 1 hour of arrival at hospital Number of patients scanned within 24 hours of arrival at hospital Number of patients who arrived on stroke bed within 4 hours of hospital arrival (when hospital arrival was out of hours) Number of patients seen by stroke consultant or associate specialist within 24h Number of patients with a known time of onset for stroke symptoms Number of patients for whom their prognosis/diagnosis was discussed with relative/carer within 72h where applicable 1791 (33%)5050 (92%)1735 (54%)4830 (79%)3262 (54%)5010 (87%) Quarterly data April – June 2011 The above table shows key indicators 1-6 across all hospitals, with the number (and percentage) of patients who received each standard. Contents Page last viewed End Next part of table

7. Key Indicator 7Key Indicator 8Key Indicator 9Key Indicator 10Key Indicator 11Key Indicator 12 Average Number of patients who had continence plan drawn up within 72h where applicable Number of potentially eligible patients thrombolysed Bundle 1: Seen by nurse and one therapist within 24h and all relevant therapists within 72h (proxy for NICE QS 5) Bundle 2: Nutrition screening and formal swallow assessment within 72 hours where appropriate Bundle 3: Patient's first ward of admission was stroke unit and they arrived there within four hours of hospital arrival Bundle 4: Patient given antiplatelet within 72h where appropriate and had adequate fluid and nutrition in all 24h periods Average of 12 key indicators 1406 (62%)362 (52%)2734 (53%)4502 (85%)3187 (55%)3275 (63%)64 The above table shows key indicators 7-12 across all hospitals, with the number (and percentage) of patients who received each standard. It also shows the average of the 12 key indicators. Contents Page last viewed End Quarterly data April – June 2011 Previous part of table

8. Number of patients Contents Page last viewed End

9. Key Indicator 1 Key indicators Number of patients scanned within 1 hour of arrival at hospital –This is for stroke patients only. Patients who were already in hospital at the time of stroke are not included, as arrival time is irrelevant here. This indicator is for Accelerating Stroke improvement (ASI) Metric 4 (and is also linked to NICE Quality Standard 2). Contents Page last viewed End Graph

10. Key Indicator 1 Key indicators Number of patients scanned within 1 hour of arrival at hospital Contents Page last viewed End Information

11. Key Indicator 2 Key indicators Number of patients scanned within 24 hours of arrival at hospital –This is for stroke patients only. Patients who were already in hospital at the time of stroke are not included as arrival time is irrelevant here. This indicator is for ASI Metric 4. Contents Page last viewed End Graph

12. Key Indicator 2 Key indicators Number of patients scanned within 24 hours of arrival at hospital Contents Page last viewed End Information

13. Key Indicator 3 Key indicators Number of patients who arrived on stroke bed within 4 hours of hospital arrival (when hospital arrival was out of hours) –This is based on stroke patients who arrived out of hours. Out of hours means the patient arrived after 6pm or before 8am Monday-Friday, or at the weekend or on a Bank Holiday. Patients who were already in hospital at the time of stroke are not included as arrival time is irrelevant here. This indicator is used to distinguish hospitals which have well organised direct admission to stroke units 'out of hours'. Contents Page last viewed End Graph

14. Key Indicator 3 Key indicators Number of patients who arrived on stroke bed within 4 hours of hospital arrival (when hospital arrival was out of hours) Contents Page last viewed End Information

15. Key Indicator 4 Key indicators Number of patients seen by stroke consultant or associate specialist within 24 hours –This is for stroke patients only. Patients already in hospital at the time of stroke are included (onset time would be the ‘0’ hour here, whereas for newly admitted patients the ‘0’ hour is the time of arrival at hospital). Contents Page last viewed End Graph

16. Key Indicator 4 Key indicators Number of patients seen by stroke consultant or associate specialist within 24 hours Contents Page last viewed End Information

17. Key Indicator 5 Key indicators Number of patients with a known time of onset for stroke symptoms –This is based on stroke patients only. It includes patients who were already in hospital at time of stroke. This is included as a key indicator to reward those services which are putting effort into establishing the onset time for more of their patients. Also, it contributes to higher quality and more useful data, as more standards can be measured according to onset time. Contents Page last viewed End Graph

18. Key Indicator 5 Key indicators Number of patients with a known time of onset for stroke symptoms Contents Page last viewed End Information

19. Key Indicator 6 Key indicators Number of patients for whom their prognosis/diagnosis was discussed with relative/carer within 72 hours where applicable –This is for stroke patients only. Patients already in hospital at the time of stroke are included. This is used as a key indicator as it is a measure which looks at whether hospitals are involving carers/relatives. Contents Page last viewed End Graph

20. Key Indicator 6 Key indicators Number of patients for whom their prognosis/diagnosis was discussed with relative/carer within 72 hours where applicable Contents Page last viewed End Information

21. Key Indicator 7 Key indicators Number of patients who had a continence plan drawn up within 72 hours where applicable –This is for stroke patients only. This includes patients already in hospital at the time of stroke. The management of continence is consistently highlighted by patients as being one of the most important aspects of care. Contents Page last viewed End Graph

22. Key Indicator 7 Key indicators Number of patients who had a continence plan drawn up within 72 hours where applicable Contents Page last viewed End Information

23. Key Indicator 8 Key indicators Number of potentially eligible patients thrombolysed –Eligible patients are those with infarction; aged 80 and under; whose onset of stroke to arrival at hospital time was less than 3 hours or who had their stroke in hospital; who did not refuse treatment; and who were not contra- indicated due to co-morbidity, medication or another reason. This is linked to NICE Quality Standard 3. Contents Page last viewed End Graph

24. Key Indicator 8 Key indicators Number of potentially eligible patients thrombolysed Contents Page last viewed End Information

25. Key Indicator 9 Key indicators Bundle 1: Seen by a nurse and one therapist within 24 hours and all relevant therapists within 72 hours (proxy for NICE Quality Standard 5) –This is for stroke patients only. This includes patients already in hospital at the time of stroke. This is linked to NICE Quality Standard 5 but does not have 'documented multidisciplinary goals agreed within 5 days' which is part of the NICE Quality Standard. (This is because this is outside of SINAP’s 72 hour remit). Contents Page last viewed End Graph

26. Key Indicator 9 Key indicators Bundle 1: Seen by a nurse and one therapist within 24 hours and all relevant therapists within 72 hours (proxy for NICE Quality Standard 5) Contents Page last viewed End Information

27. Key Indicator 10 Key indicators Bundle 2: Nutrition screening and formal swallow assessment within 72 hours where appropriate –This is for stroke patients only. This includes patients already in hospital at the time of stroke. Contents Page last viewed End Graph

28. Key Indicator 10 Key indicators Bundle 2: Nutrition screening and formal swallow assessment within 72 hours where appropriate Contents Page last viewed End Information

29. Key Indicator 11 Key indicators Bundle 3: Patient's first ward of admission was stroke unit and they arrived there within four hours of hospital arrival –This is for stroke patients only. Patients who were already in hospital at the time of stroke are not included as arrival at hospital time is irrelevant here. This is ASI Metric 2 (and is also linked to NICE Quality Standard 3). Contents Page last viewed End Graph

30. Key Indicator 11 Key indicators Bundle 3: Patient's first ward of admission was stroke unit and they arrived there within four hours of hospital arrival Contents Page last viewed End Information

31. Key Indicator 12 Key indicators Bundle 4: Patient given antiplatelet within 72 hours where appropriate and had adequate fluid and nutrition in all 24 hour periods –This is for stroke patients only. This includes patients already in hospital at the time of stroke. Contents Page last viewed End Graph

32. Key Indicator 12 Key indicators Bundle 4: Patient given antiplatelet within 72 hours where appropriate and had adequate fluid and nutrition in all 24 hour periods Contents Page last viewed End Information

33. Average 12 Key Indicators This is only a guide for where hospitals sit in relation to each other, and could be different if other key indicators are used. It is also a guide for hospitals in isolation, to see how much room there is for improvement and to look at which indicators in particular are making the overall score better or worse (therefore highlighting specific areas for praise or improvement). This average may also provide a useful indication of how the stroke service is performing over time. Contents Page last viewed End Graph

34. Contents Page last viewed End Information Average 12 Key Indicators

35. Key to box plots Contents Page last viewed End

36. Lowest* value of the data range Lower quartile* (25 percentile, i.e. the value at 25% of the ordered data set) Median* (the ‘middle’ value) Upper quartile* (75 percentile) Highest* value of the data range Anomalies: these are data values that are significantly outside the data range and are hence discounted from statistical calculations. *Excluding anomalous data values Key to the box plots Box plots Contents Page last viewed End

37. Feedback We are keen to have feedback on this presentation, and particularly if you have used it for quality improvement purposes. Please send feedback to: sinap@rcplondon.ac.uk sinap@rcplondon.ac.uk For more information, please visit: www.rcplondon.ac.uk/sinap Contents Page last viewed End