BACKGROUND AND PURPOSE: Approximately 23% of Australian hospitals provide Stroke Units (SUs). Evidence suggests that clinical outcomes are better in SUs than with conventional care. Reasons may include greater adherence to processes of care (PoC). The primary hypothesis was that adherence to selected PoC is greater in SUs than in other acute care models. METHODS: Prospective, multicenter, single-blinded design. Models of care investigated: SUs, mobile services, and conventional care. Selected PoC were related to care models and participant outcomes. Data were collected at acute hospitalization (median 9 days) and at medians of 8 and 28 weeks after stroke. RESULTS: 1701 patients were screened from 8 hospitals, 823 were eligible, and 468 participated. Response rate was 96% at final follow-up. Mean age was 73 years (SD 14). Overall PoC adherence rates for individual care models were SU 75%, mobile service 65%, and conventional care 52% (P<0.001). The adjusted odds of participants being alive at discharge if adhering to all or all but 1 PoC was significant (aOR 3.63; 95% CI: 1.04 to 12.66; P=0.043). Important trends at 28 weeks were found for being at home (aOR 3.09; 95% CI: 0.96 to 9.87; P=0.058) and independent (aOR 2.61; 95% CI: 0.96 to 7.10; P=0.061), with complete PoC adherence. CONCLUSIONS: Adherence to key PoC was higher in SUs than in other models. For all patients, adherence to PoC was associated with improved mortality at discharge and trends found with independence at home, providing support for the need to increase access to stroke units.
BACKGROUND AND PURPOSE: Approximately 23% of Australian hospitals provide Stroke Units (SUs). Evidence suggests that clinical outcomes are better in SUs than with conventional care. Reasons may include greater adherence to processes of care (PoC). The primary hypothesis was that adherence to selected PoC is greater in SUs than in other acute care models. METHODS: Prospective, multicenter, single-blinded design. Models of care investigated: SUs, mobile services, and conventional care. Selected PoC were related to care models and participant outcomes. Data were collected at acute hospitalization (median 9 days) and at medians of 8 and 28 weeks after stroke. RESULTS: 1701 patients were screened from 8 hospitals, 823 were eligible, and 468 participated. Response rate was 96% at final follow-up. Mean age was 73 years (SD 14). Overall PoC adherence rates for individual care models were SU 75%, mobile service 65%, and conventional care 52% (P<0.001). The adjusted odds of participants being alive at discharge if adhering to all or all but 1 PoC was significant (aOR 3.63; 95% CI: 1.04 to 12.66; P=0.043). Important trends at 28 weeks were found for being at home (aOR 3.09; 95% CI: 0.96 to 9.87; P=0.058) and independent (aOR 2.61; 95% CI: 0.96 to 7.10; P=0.061), with complete PoC adherence. CONCLUSIONS: Adherence to key PoC was higher in SUs than in other models. For all patients, adherence to PoC was associated with improved mortality at discharge and trends found with independence at home, providing support for the need to increase access to stroke units.
Authors: Judith A Hinchey; Timothy Shephard; Sarah T Tonn; Robin Ruthazer; Richard C Hermann; Harry P Selker; David M Kent Journal: J Stroke Cerebrovasc Dis Date: 2010-03 Impact factor: 2.136
Authors: Hong-Kyun Park; Seong-Eun Kim; Yong-Jin Cho; Jun Yup Kim; Hyunji Oh; Beom Joon Kim; Jihoon Kang; Keon-Joo Lee; Min Uk Jang; Jong-Moo Park; Kwang-Yeol Park; Kyung Bok Lee; Soo Joo Lee; Ji Sung Lee; Juneyoung Lee; Ki Hwa Yang; Ah Rum Choi; Mi Yeon Kang; Eric E Smith; Philip B Gorelick; Hee-Joon Bae Journal: Eur Stroke J Date: 2019-05-24
Authors: Ruth E Hall; Ferhana Khan; Mark T Bayley; Eriola Asllani; Patrice Lindsay; Michael D Hill; Christina O'Callaghan; Frank L Silver; Moira K Kapral Journal: Int J Qual Health Care Date: 2013-10-17 Impact factor: 2.038
Authors: Christine L Paul; Christopher R Levi; Catherine A D'Este; Mark W Parsons; Christopher F Bladin; Richard I Lindley; John R Attia; Frans Henskens; Erin Lalor; Mark Longworth; Sandy Middleton; Annika Ryan; Erin Kerr; Robert W Sanson-Fisher Journal: Implement Sci Date: 2014-03-25 Impact factor: 7.327