Effectiveness of a clinical pathway for acute stroke care in a district general hospital: an audit

BMC Health Services Research
William J TaylorHarry K McNaughton

Abstract

Organised stroke care saves lives and reduces disability. A clinical pathway might be a form of organised stroke care, but the evidence for the effectiveness of this model of care is limited. This study was a retrospective audit study of consecutive stroke admissions in the setting of an acute general medical unit in a district general hospital. The case-notes of patients admitted with stroke for a 6-month period before and after introduction of the pathway, were reviewed to determine data on length of stay, outcome, functional status, (Barthel Index, BI and Modified Rankin Scale, MRS), Oxfordshire Community Stroke Project (OCSP) sub-type, use of investigations, specific management issues and secondary prevention strategies. Logistic regression was used to adjust for differences in case-mix. N = 77 (prior to the pathway) and 76 (following the pathway). The median (interquartile range, IQR) age was 78 years (67.75-84.25), 88% were European NZ and 37% were male. The median (IQR) BI at admission for the pre-pathway group was less than the post-pathway group: 6 (0-13.5) vs. 10 (4-15.5), p = 0.018 but other baseline variables were statistically similar. There were no significant differences between any of the outcome or process of c...Continue Reading

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References

Nov 1, 1988·Stroke; a Journal of Cerebral Circulation·R F Bloch
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Citations

Jul 13, 2011·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·George A LopezOwen Samuels
Feb 25, 2009·International Journal of Stroke : Official Journal of the International Stroke Society·Blanca Fuentes, Exuperio Díez-Tejedor
Apr 23, 2009·International Journal of Stroke : Official Journal of the International Stroke Society·T PurvisJ Bernhardt
Apr 7, 2009·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Jack D McCueKevin Smothers
Apr 26, 2019·International Journal of Health Care Quality Assurance·Antonio Giulio de BelvisMaria Lucia Specchia

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