Abstract NS5: Feasibility of an Electronic Point-of-Discharge Tablet for Collection of Perception of Stroke Care Quality Data

Abstract

Background: Perception of hospital quality is typically collected from mailed surveys distributed to a random sample of discharges. These surveys capture few strokes, and fail to capture data addressing preparedness for transition to home, ability to identify/respond to stroke symptoms, or perceptions tied to acute stroke team performance. We sought to determine the feasibility of using an iPAD™ for collection of stroke perception of care data using the reliable/valid STROKE Perception Report (SPR) instrument. Methods: A cloud-based SPR database was established and IRB approval was obtained at 5 U.S. study sites. Consecutive stroke patients were offered an iPAD™ for data entry immediately prior to discharge. Families completed the survey for patients with severe stroke. Data were downloaded for analysis in SPSS. Results: A total of 153 surveys were collected with 101 (67%) collected from stroke patients averaging 62+/-14 years (median 62, range 19-94 years). Subjects were 74% White, 14% African American, 6% Asian, 2% Native Hawaiian/Pacific Islander, and 4% Native American/Alaskan Native; 17% were Hispanic. Education was: 37% high school (HS) graduates, 26% some college, 20% college graduates, 12% >college degree, and 5% some HS. The median score for difficulty was 4 (easy to use); only 2% (patients) rated data entry difficult. No users rated their entries as “at risk for confidentiality/privacy loss,” and 77% perceived entries as “more confidential” than paper entries. Of note, 62% indicated that they do not respond to mailed surveys. There was no difference in “ease of use” or “confidentiality protection” by patients, families, or race, however, higher levels of education with associated with perceptions of improved confidentiality (Chi Square 16.3; p=0.039). Interestingly, as patient age increased, perceptions of difficulty of use decreased (r=.29; p=0.029). Conclusions: Use of an electronic tablet to collect important perception of care data in stroke patients or family at discharge is feasible, and may constitute an improved method for obtaining sample sizes sufficient to draw conclusions about stroke service quality. Our findings support use of a discharge data collection model that can be widely disseminated regardless of age and education.