Stroke in-hospital length of stay 3 or more days Age group, septicaemia, A rate reflects higher quality Recommended change: mortality. unless the patient died in malignancy, heart failure, (Review 2012) Patients who change: Publicly reporting: hospital acute lower respiratory died in hospital and had a to include The Hospital Performance tract infection and Recommended from 2012 review length of stay less than or equal 18-29 years Reports are no longer available influenza, and renal not yet incorporated into to 30 days. – publicly on the website. At the failure. specifications: Denominator time of the last literature review Inclusion of all in hospital Recommended: in 2009, the 2004 data was Current: Patients with a Year: 2012 mortalities To remove septicaemia available publicly. principal diagnosis of Expand age of patients to and acute respiratory Intracerebral haemorrhage; Hospital reporting include those aged 18‐29 tract infection and other non-traumatic years Via secure online platform include risk adjustment intracranial haemorrhage; Linkage of episodes across provided in partnership with . for stroke type: cerebral infarction; or stroke; hospitals to be the same as Features of the website include not specified as haemorrhage Age group linkage within hospitals, i.e. charting to show performance – or infarction Heart failure link to subsequent acute against control limits for a Malignancy stroke episodes or other selected indicator and facility. Renal Failure non‐acute episodes Includes systems for actioning Stroke type (as defined Transfers out from the initial performance results found to be by ICD code block: I61, hospital providing acute outside the control limits. The I62, I63, or I64) treatment are included, as are Opus 5 website also includes to pg 8 for transfers in and out of functionality for analysing rationale of risk subsequent hospitals in a causes and determining adjustment single of care’. A workflow to address quality ‘continuum recommendations. transferred case is defined as issues. either: an admission to a VLAD is updated on a monthly. A subsequent hospital within 12 flag is initiated where the VLAD hours of separation from the line meets the lower or upper previous hospital OR an control limits. admission to a subsequent hospital within 36 hours with indication of either a ‘transfer out’ or a in’ ‘transfer Exclusion criteria: Current transfers in transfers out changes of episode type, and
Stroke in-hospital mortality. Year: 2012 Recommended change: (Review 2012) Patients who died in hospital and had a length of stay less than or equal to 30 days. Denominator Current: Patients with a principal diagnosis of Intracerebral haemorrhage; other non-traumatic intracranial haemorrhage; cerebral infarction; or stroke; not specified as haemorrhage or infarction length of stay 3 or more days unless the patient died in hospital Recommended from 2012 review – not yet incorporated into specifications: Inclusion of all in hospital mortalities Expand age of patients to include those aged 18‐29 years Linkage of episodes across hospitals to be the same as linkage within hospitals, i.e. – link to subsequent acute stroke episodes or other non‐acute episodes Transfers out from the initial hospital providing acute treatment are included, as are transfers in and out of subsequent hospitals in a single ‘continuum of care’. A transferred case is defined as either: an admission to a subsequent hospital within 12 hours of separation from the previous hospital OR an admission to a subsequent hospital within 36 hours with indication of either a ‘transfer out’ or a ‘transfer in’ Exclusion criteria: Current transfers in transfers out changes of episode type, and change: to include 18-29 years Age group, septicaemia, malignancy, heart failure, acute lower respiratory tract infection and influenza, and renal failure. Recommended: To remove septicaemia and acute respiratory tract infection and include risk adjustment for stroke type: Age group Heart failure Malignancy Renal Failure Stroke type (as defined by ICD code block: I61, I62, I63, or I64) to pg 8 for rationale of risk adjustment recommendations. A rate reflects higher quality Publicly reporting: The Hospital Performance Reports are no longer available publicly on the website. At the time of the last literature review in 2009, the 2004 data was available publicly. Hospital reporting Via secure online platform provided in partnership with . Features of the website include charting to show performance against control limits for a selected indicator and facility. Includes systems for actioning performance results found to be outside the control limits. The Opus 5 website also includes functionality for analysing causes and determining workflow to address quality issues. VLAD is updated on a monthly. A flag is initiated where the VLAD line meets the lower or upper control limits.