SINAP Results First Quarterly Public Report

1. SINAP Results First Quarterly Public Report July 2010 – June 2011 admissions An interactive slideshow allowing you to click on links to take you to the key indicators that you want to see. For example, you can click on a key indicator link on the next page to take you to its description. Then you can click on “Graph” to see a graph of national figures for that indicator.

2. Contents Key Indicator 7 Annual data Quarterly data Key Indicator 8 Number of patients Key Indicator 9 Key Indicator 1 Key Indicator 10 Key Indicator 2 Key Indicator 11 Key Indicator 12 Key Indicator 3 Key Indicator 4 Average of 12 KIs Key Indicator 5 Box plots Feedback Key Indicator 6

3. Annual data July 2010 – June 2011 • The above table shows key indicators 1-6 across all hospitals, with the number (and percentage) of patients who received each standard. Next part of table Contents

4. Annual data July 2010 – June 2011 • The above table shows key indicators 7-12 across all hospitals, with the number (and percentage) of patients who received each standard. It also shows the average of the 12 key indicators. Previous part of table Contents

5. Quarterly data April – June 2011 • The above table shows key indicators 1-6 across all hospitals, with the number (and percentage) of patients who received each standard. Next part of table Contents

6. Quarterly data April – June 2011 • The above table shows key indicators 7-12 across all hospitals, with the number (and percentage) of patients who received each standard. It also shows the average of the 12 key indicators. Previous part of table Contents

7. Number of stroke patients per month Contents

8. Key indicators • Number of patients scanned within 1 hour of arrival at hospital • This is for stroke patients only. Patients who were already in hospital at the time of stroke are not included, as arrival time is irrelevant here. This indicator is for Accelerating Stroke improvement (ASI) Metric 4 (and is also linked to NICE Quality Standard 2). Graph Contents

9. Key indicators • Number of patients scanned within 1 hour of arrival at hospital Information Contents

10. Key indicators • Number of patients scanned within 24 hours of arrival at hospital • This is for stroke patients only. Patients who were already in hospital at the time of stroke are not included as arrival time is irrelevant here. This indicator is for ASI Metric 4. Graph Contents

11. Key indicators • Number of patients scanned within 24 hours of arrival at hospital Information Contents

12. Key indicators • Number of patients who arrived on stroke bed within 4 hours of hospital arrival (when hospital arrival was out of hours) • This is based on stroke patients who arrived out of hours. Out of hours means the patient arrived after 6pm or before 8am Monday-Friday, or at the weekend or on a Bank Holiday. Patients who were already in hospital at the time of stroke are not included as arrival time is irrelevant here. This indicator is used to distinguish hospitals which have well organised direct admission to stroke units 'out of hours'. Graph Contents

13. Key indicators • Number of patients who arrived on stroke bed within 4 hours of hospital arrival (when hospital arrival was out of hours) Information Contents

14. Key indicators • Number of patients seen by stroke consultant or associate specialist within 24 hours • This is for stroke patients only. Patients already in hospital at the time of stroke are included (onset time would be the ‘0’ hour here, whereas for newly admitted patients the ‘0’ hour is the time of arrival at hospital). Graph Contents

15. Key indicators • Number of patients seen by stroke consultant or associate specialist within 24 hours Information Contents

16. Key indicators • Number of patients with a known time of onset for stroke symptoms • This is based on stroke patients only. It includes patients who were already in hospital at time of stroke. This is included as a key indicator to reward those services which are putting effort into establishing the onset time for more of their patients. Also, it contributes to higher quality and more useful data, as more standards can be measured according to onset time. Graph Contents

17. Key indicators • Number of patients with a known time of onset for stroke symptoms Information Contents

18. Key indicators • Number of patients for whom their prognosis/diagnosis was discussed with relative/carer within 72 hours where applicable • This is for stroke patients only. Patients already in hospital at the time of stroke are included. This is used as a key indicator as it is a measure which looks at whether hospitals are involving carers/relatives. Graph Contents

19. Key indicators • Number of patients for whom their prognosis/diagnosis was discussed with relative/carer within 72 hours where applicable Information Contents

20. Key indicators • Number of patients who had a continence plan drawn up within 72 hours where applicable • This is for stroke patients only. This includes patients already in hospital at the time of stroke. The management of continence is consistently highlighted by patients as being one of the most important aspects of care. Graph Contents

21. Key indicators • Number of patients who had a continence plan drawn up within 72 hours where applicable Information Contents

22. Key indicators • Number of potentially eligible patients thrombolysed • Eligible patients are those with infarction; aged 80 and under; whose onset of stroke to arrival at hospital time was less than 3 hours or who had their stroke in hospital; who did not refuse treatment; and who were not contra-indicated due to co-morbidity, medication or another reason. This is linked to NICE Quality Standard 3. Graph Contents

23. Key indicators • Number of potentially eligible patients thrombolysed Information Contents

24. Key indicators • Bundle 1: Seen by a nurse and one therapist within 24 hours and all relevant therapists within 72 hours (proxy for NICE Quality Standard 5) • This is for stroke patients only. This includes patients already in hospital at the time of stroke. This is linked to NICE Quality Standard 5 but does not have 'documented multidisciplinary goals agreed within 5 days' which is part of the NICE Quality Standard. (This is because this is outside of SINAP’s 72 hour remit). Graph Contents

25. Key indicators • Bundle 1: Seen by a nurse and one therapist within 24 hours and all relevant therapists within 72 hours (proxy for NICE Quality Standard 5) Information Contents

26. Key indicators • Bundle 2: Nutrition screening and formal swallow assessment within 72 hours where appropriate • This is for stroke patients only. This includes patients already in hospital at the time of stroke. Graph Contents

27. Key indicators • Bundle 2: Nutrition screening and formal swallow assessment within 72 hours where appropriate Information Contents

28. Key indicators • Bundle 3: Patient's first ward of admission was stroke unit and they arrived there within four hours of hospital arrival • This is for stroke patients only. Patients who were already in hospital at the time of stroke are not included as arrival at hospital time is irrelevant here. This is ASI Metric 2 (and is also linked to NICE Quality Standard 3). Graph Contents

29. Key indicators • Bundle 3: Patient's first ward of admission was stroke unit and they arrived there within four hours of hospital arrival Information Contents

30. Key indicators • Bundle 4: Patient given antiplatelet within 72 hours where appropriate and had adequate fluid and nutrition in all 24 hour periods • This is for stroke patients only. This includes patients already in hospital at the time of stroke. Graph Contents

31. Key indicators • Bundle 4: Patient given antiplatelet within 72 hours where appropriate and had adequate fluid and nutrition in all 24 hour periods Information Contents

32. Average 12 Key Indicators • This is an unweighted average (mean) of the key indicators. • This is a guide for benchmarking across all hospitals. • This average may also provide a useful indication of how the stroke service is performing over time. Graph Contents

33. Average 12 Key Indicators Information Contents

34. Contents Key to box plots

35. Key to the box plots Median* (the ‘middle’ value) Anomalies: these are data values that are significantly outside the data range and are hence discounted from statistical calculations. Lowest* value of the data range Highest* value of the data range Upper quartile* (75 percentile) Lower quartile* (25 percentile, i.e. the value at 25% of the ordered data set) *Excluding anomalous data values Box plots Contents

36. Feedback • We are keen to have feedback on this presentation, and particularly if you have used it for quality improvement purposes. • Please send feedback to: sinap@rcplondon.ac.uk • For more information, please visit: • www.rcplondon.ac.uk/sinap Contents