1 / 22

REGIONS Care – update

This update outlines the progress of the REGIONS.Care observational study, which aims to monitor stroke care in public hospitals in New Zealand. The study focuses on the impact of DHB size, location, and ethnicity on stroke service access and related health outcomes. The study coordinator role, data cleaning, analysis, and future plans are discussed.

gdolan
Download Presentation

REGIONS Care – update

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. REGIONS Care – update A/Prof Anna Ranta – Lead Investigator Stephanie Thompson – Study Coordinator

  2. Outline of REGIONS Care • Observational study monitoring stroke care in NZ public hospitals • Objectives: • Impact of DHB size and location on stroke service access & stroke and related health outcomes • Impact of ethnicity on stroke service access and stroke and related health outcomes

  3. What have we done to date? 2548 entries – duplicates, non-stroke diagnosis 1086 consented for extended follow-up • 28 hospitals • Data cleaning underway – missing data • Data analysis • Present results at Rehab Quality Day – June 6th

  4. What have we done so far? • 955 calls completed • Attempted to contact 1078 participants North and South Island locations 4-6 participants per group Online surveys

  5. Study Coordinator role

  6. Some thoughts about the role... • Clinical background in stroke management (rehab) • Acute stroke management...a steep learning curve • The challenge of phoning participants

  7. What’s next? • 12 month calls • Complete end Oct/early November • 3 more focus groups – Invercargill, Hawke’s Bay, Rotorua • November onwards – data cleaning, analysis, write-up, presentation of results • Some results likely early 2020

  8. Data linkage and other bits • As part of this study we will link our data to compare to NZ statistics data (including MoH discharge data) • We have started work on developing the data set and are making good progress • This will allow us (hopefully) to expand our data set to up to 8,000 stroke patients and add additional findings about ethnic differences • We will also do a cost-benefit analysis of the work involved in keeping a register and if found helpful apply to MoH for funding to help you all to gather future data • This will take a bit longer and we don’t expect these results until late 2020/early 2021.

  9. A request... • Some missing data: • Organisational survey • Incomplete audit forms – please check if yours are complete

  10. Stroke Clot Retrieval Update Anna Ranta Clinical Director National Stroke Clot Retrieval Service Improvement Programme

  11. Number of clot retrieval cases in NZ

  12. Clot retrieval rates in NZ

  13. NSN NZ Clot Retrieval Strategy November 2016 – ‘received’ but not formally endorsed by the Ministry or Minister of Health as a National Service Priority

  14. National Stroke Clot Retrieval Service Improvement Programme • Formal MoH support sought beginning in November 2016 • Outcome received in April 2018: ‘Nat’l Service Improvement Programme’ • Advisory Group formed • EOI request via DHB CEOs • Meeting 22 August Wellington – 42 attendees • Clinical Director appointed 1 October • Advisory Group identified 5 priority areas • Detailed content in each priority area worked on by five separate su-groups involving additional teleconferences • Advisory Group also agreed NZ official name will be: Stroke Clot Retrieval (SCR)

  15. Consultation Process • Sector wide consultation December 2018 through March 2019 • 45 Responses received

  16. Follow-up 2 hr Zoom MeetingTuesday 30 April • Discussion Points: • Māori/Pacific indicators • Remove ‘ideally’ as part of CTP provision • Increase emphasis on impact on clinicians other than INRs especially nurses • Increase emphasis on paramedic education/quality/speed/triage • Outcome measures: transport to home DHB, clinician surveys • Clarify that quality measures include DTG, DIDO, TICI etc • Approach to border-zone DHBs and adding additional SCR centres specifically Waikato • Inclusion of telestroke • Regional versus National approach to implementation

  17. Next Steps • Meeting minutes to be approved by advisory group over next two weeks • Implementation plan finalised by end of May • Approval sought from MoH Governance Group in June • Minister of Health shortly after • At that point this becomes a national priority and DHBs will have deliver on this as part of their work programme/annual plans • In addition, central support should continue to drive the implementation process at the national level

  18. Next Steps • Pending MoH $ support a smaller SCR/hyper-acute working-group will be formed to guide the actual implementation e.g.: • Develop nationally and cross discipline agreed triage and selection protocols/guidelines • Work with National Radiology Advisory Group to define advanced imaging pathways • Establish a national quality frame work (maintaining a focus on patient-centred and culturally appropriate care) • Engage with ambulance/flight teams to optimise patient transfers • Facilitate telestroke network implementation and additional SCR centres • Negotiate funding • Establish referral patterns to optimise resources nationally and maximise quality and equity for all New Zealanders

  19. Any Questions?

More Related