Transcript Document
WEST GTA LHIN STROKE REPORT CARDS Stroke Report Card Indicators 20 indicators • Integral to access, efficiency, effectiveness and integration that span the continuum of care (3 HSAA indicators – 8,11,20) Provincial benchmarks set to enable comparison within and across LHINs • Achievable Benchmarks of Care (ABC) methodology • Colour coded to indicate performance relative to benchmark Provincial, LHIN and subLHIN data • Ontario Stroke Audit (10/11) (RSC 100% of stroke pop ’n – Other 30% stroke pop ’n) • Canadian Institute for Health Information (10/11) Provincial Report Card LHIN Report Card WEST GTA STROKE Report Card (2010/11) Areas OF Improvement: • (1) Public Awareness and Education: % of stroke patients who arrive at ED < 3.5 hours from stroke onset Provincial Benchmark – 52% • (7) Acute Stroke Management: % of ischemic stroke patients who arrived at ED less than 3.5 hours from symptom onset and received t-PA Provincial Benchmark – 61.2% Mississauga/Halton LHIN Stroke Report Card (2010/11) Areas FOR Improvement: • (4) Prevention: % of ischemic stroke/TIA patients with Atrial Fibrillation prescribed or recommended anticoagulant therapy upon Discharge from hospital PB = 86% • (8) Acute Stroke: % of stroke/TIA patients treated on a stroke unit at any time during their inpatient stay PB = 87.5% • (10) Acute Stroke: % of ALC days to total length of stay in acute care PB = 14% • (11) Acute Stroke: % of acute stroke patients discharged from acute care and admitted to inpatient rehabilitation PB 42.3% Mississauga/Halton LHIN Stroke Report Card (2010/11) Areas FOR Improvement: • (13) Stroke Rehabilitation: % of stroke (excluding TIA) patients discharged from acute care who received a referral for outpatient rehabilitation PB = 12.1% • (18) Stroke Rehabilitation: % of stroke patients admitted to inpatient rehabilitation with severe strokes (RPG 1100 or 1110 PB = 46.9% Stroke Reference Group Recommendations Endorsed by the Rehab/CCC Expert Panel (March 2011) Emergency Care • Best Practice Standards: • Protocols/Order sets/Algorithms to manage stroke/TIA patients • Minimize LOS • Proposed Metrics: • LOS • Admission to stroke unit • CT scan within 24 hours of admission Stroke Reference Group Recommendations Endorsed by the Rehab/CCC Expert Panel (March 2011) Acute Care • Best Practice Standards: • • • • Should be treated on a inter-professional stroke unit (Evidence Level A) AlphaFIM® completed on Day 3 Initiate discharge planning Mobilize patient within 24 hours of admission • Proposed Metrics: • • • • • • • % admitted to stroke unit Onset to rehab (5-7 days) AlphaFIM® completed on Day 3 % of patients with ALC days All cause of readmission rates % of pts. with AlphaFIM® categories D/C to planned rehab destination % D/C to inpatient rehab Stroke Reference Group Recommendations Endorsed by the Rehab/CCC Expert Panel (March 2011) Inpatient Rehabilitation • Best Practice Standards: • • • • • Stroke Rehab Unit Minimum of 3 hours of direct, individualized therapy/day 7 day/week services 7 day/week Rehab ALC has priority access to LTC • Proposed Metrics: • Provincial workload definition of direct minutes of therapy per day (therapist vs. assistant) • Discharge destination • ALC LOS • ALC rates per X patients • All cause readmission rates • FIM efficiency by RPG Stroke Reference Group Recommendations Endorsed by the Rehab/CCC Expert Panel (March 2011) Ambulatory Rehabilitation/Community Care • Best Practice Standards: • Ambulatory rehab model (CCAC, community based, hospital based) • Decrease admission of mild strokes through increased access to early outpatient rehab for those within high early outpatient rehab for those with high early FIM • Access to enhance attendant care/supports in early discharge phase for ALC pts. • Outpt. or enhanced CCAC therapy visits: 2-3 visits/week for 12 weeks • Proposed Metrics: • CCAC referral date • Time for first CCAC visit • Readmission rate WEST GTA STROKE NETWORK 3 priorities for the West GTA Stroke Network Region… 1) 2) 3) THANK YOU!