Abstract
This article considers the question if measurable improvements are achieved in the quality of care in stroke services by using a Breakthrough collaborative quality improvement model. Despite the availability of explicit criteria, evidence based guidelines, national protocols and examples of best practices; stroke care in the Netherlands did not improve substantially yet. For that reason a national collaborative started in 2002 to improve integrated stroke care in 23 self selected stroke services. Characteristics of sites, teams, aims and changes were assessed by using a questionnaire and monthly self-reports of teams. Progress in achieving significant quality improvement has been assessed on a five point Likert scale (IHI score). The stroke services (n=23) formed multidisciplinary teams, which worked together in a collaborative based on the IHI Breakthrough Series Model. Teams received instruction in quality improvement, reviewed self reported performance data, identified bottlenecks and improvement goals, and implemented "potentially better practices" based on criteria from the Edisse study, evidence based guidelines, own ideas and expert opinion. Quality of care has been improved in most participating stroke services. Eighty-seven percent of the teams have improved their care significantly on at least one topic. About 34% of the teams have achieved significant improvement on all aims within the time frame of the project. The project has contributed to the further development and spread of integrated stroke care in the Netherlands.
Highlights
Stroke is a severe health care problem
This article considers the question if measurable improvements are achieved in the quality of care in stroke services by using a Breakthrough collaborative quality improvement model
The results showed that integrating stroke services may lead to organisational improvements, improved patient and professional satisfaction, higher efficiency and better patient outcomes by reducing hospital length of stay and inappropriate hospital days
Summary
Stroke is a severe health care problem. Stroke is a major and growing cause of death, long-term disability and health care costs [1, 2]. In the Netherlands, every year 30,000 people are hit by a stroke. Ageing of the Dutch population will increase the incidence of stroke by 30% in 2015 [3]. One third of patients with a first stroke die within 36 months and about 60% survive with moderate or severe handicaps [4]. In 1999, stroke has been the third leading cause of death in the Netherlands [5] and responsible for 2.9% of its total health care costs, and for 6.0% in the population aged 75 and over. Therewith stroke ranks second on the list of most costly diseases for the elderly, after dementia [6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
