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 Page last viewed Contents End

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 Page last viewed Contents End

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 Page last viewed Contents End

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 Page last viewed Contents End

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 Page last viewed Contents End

7. Number of patients Page last viewed Contents End

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 Page last viewed Contents End

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

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 Page last viewed Contents End

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

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 Page last viewed Contents End

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 Page last viewed Contents End

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 Page last viewed Contents End

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

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 Page last viewed Contents End

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

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 Page last viewed Contents End

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

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 Page last viewed Contents End

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

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 Page last viewed Contents End

23. Key indicators • Number of potentially eligible patients thrombolysed Information Page last viewed Contents End

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 Page last viewed Contents End

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 Page last viewed Contents End

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 Page last viewed Contents End

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

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 Page last viewed Contents End

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 Page last viewed Contents End

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 Page last viewed Contents End

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 Page last viewed Contents End

32. Average 12 Key Indicators • This is only a guide for where hospitals sit in relation to each other, and could be different if other key indicators are used. • It is also a guide for hospitals in isolation, to see how much room there is for improvement and to look at which indicators in particular are making the overall score better or worse (therefore highlighting specific areas for praise or improvement). • This average may also provide a useful indication of how the stroke service is performing over time. Graph Page last viewed Contents End

33. Average 12 Key Indicators Information Page last viewed Contents End

34. Page last viewed Contents End 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 Page last viewed Contents End

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 Page last viewed Contents End