Please use this identifier to cite or link to this item:
https://ahro.austin.org.au/austinjspui/handle/1/10690
Full metadata record
DC Field | Value | Language |
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dc.contributor.author | Cadilhac, Dominique A | en |
dc.contributor.author | Pearce, D C | en |
dc.contributor.author | Levi, Christopher R | en |
dc.contributor.author | Donnan, Geoffrey A | en |
dc.date.accessioned | 2015-05-16T00:13:24Z | |
dc.date.available | 2015-05-16T00:13:24Z | |
dc.date.issued | 2008-10-01 | en |
dc.identifier.citation | Quality & Safety in Health Care; 17(5): 329-33 | en |
dc.identifier.govdoc | 18842970 | en |
dc.identifier.other | PUBMED | en |
dc.identifier.uri | https://ahro.austin.org.au/austinjspui/handle/1/10690 | en |
dc.description.abstract | Provision of evidence-based hospital stroke care is limited worldwide. In Australia, about a fifth of public hospitals provide stroke care units (SCUs). In 2001, the New South Wales (NSW) state government funded a clinician-led, health system redesign programme that included inpatient stroke services. Our objective was to determine the effects of this initiative for improving: (i) access to SCUs and care quality and (ii) health outcomes.Preintervention-postintervention design (12 months prior and a minimum 6-12 months following SCU implementation). Retrospective, public hospital audit of 50 consecutive medical records per time period of stroke admissions (using International Classification of Diseases (ICD)-10 codes). Combined analyses for 15 hospitals presented.Process of care indicators and patient independence (proportional odds modelling using modified Rankin scale).Pre-programme cases (n = 703) (mean (SD) age 74 (14) years; female: 51%) and post-programme cases (n = 884) (mean age 74 (14) years; female: 49%) were comparable. Significant post-programme improvements for most process indicators were found, such as more brain imaging within 24 hours. Post-programme, access to SCUs increased 22-fold (95% CI 16.8 to 28.3). Improvement in inpatient independence at post-programme discharge was significant compared with pre-programme outcomes (proportional odds ratio 0.73, 95% CI 0.57 to 0.94; p = 0.013) when adjusted for patient clustering and case mix.This distinctive SCU initiative was shown as effective for improving clinical practice and significantly reducing disability following stroke. | en |
dc.language.iso | en | en |
dc.subject.other | Aged | en |
dc.subject.other | Aged, 80 and over | en |
dc.subject.other | Female | en |
dc.subject.other | Health Plan Implementation | en |
dc.subject.other | Health Services Accessibility.economics | en |
dc.subject.other | Hospital Units.standards | en |
dc.subject.other | Humans | en |
dc.subject.other | Male | en |
dc.subject.other | Medical Audit | en |
dc.subject.other | Medical Records | en |
dc.subject.other | New South Wales | en |
dc.subject.other | Outcome and Process Assessment (Health Care) | en |
dc.subject.other | Patient Admission | en |
dc.subject.other | Program Evaluation | en |
dc.subject.other | Quality Indicators, Health Care | en |
dc.subject.other | Quality of Health Care | en |
dc.subject.other | Retrospective Studies | en |
dc.subject.other | Stroke.complications.therapy | en |
dc.title | Improvements in the quality of care and health outcomes with new stroke care units following implementation of a clinician-led, health system redesign programme in New South Wales, Australia. | en |
dc.type | Journal Article | en |
dc.identifier.journaltitle | Quality & safety in health care | en |
dc.identifier.affiliation | National Stroke Research Institute, Austin Health, Heidelberg Heights, Victoria, Australia | en |
dc.identifier.doi | 10.1136/qshc.2007.024604 | en |
dc.description.pages | 329-33 | en |
dc.relation.url | https://pubmed.ncbi.nlm.nih.gov/18842970 | en |
dc.contributor.corpauthor | Greater Metropolitan Clinical Taskforce and New South Wales Stroke Services Coordinating Committee | en |
dc.type.austin | Journal Article | en |
local.name.researcher | Donnan, Geoffrey A | |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.openairetype | Journal Article | - |
item.grantfulltext | none | - |
item.cerifentitytype | Publications | - |
item.fulltext | No Fulltext | - |
item.languageiso639-1 | en | - |
crisitem.author.dept | The Florey Institute of Neuroscience and Mental Health | - |
Appears in Collections: | Journal articles |
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