Dokument-ID Dokumenttyp Verfasser/Autoren Herausgeber Haupttitel Abstract Auflage Verlagsort Verlag Erscheinungsjahr Seitenzahl Schriftenreihe Titel Schriftenreihe Bandzahl ISBN Quelle der Hochschulschrift Konferenzname Quelle:Titel Quelle:Jahrgang Quelle:Heftnummer Quelle:Erste Seite Quelle:Letzte Seite URN DOI Abteilungen OPUS4-14905 Wissenschaftlicher Artikel Hillmann, Steffi; Wiedmann, Silke; Fraser, Alec; Baeza, Juan; Rudd, Anthony; Norrving, Bo; Asplund, Kjell; Niewada, Maciej; Dennis, Martin; Hermanek, Peter; Wolfe, Charles D. A.; Heuschmann, Peter U. Temporal changes in the quality of acute stroke care in five national audits across Europe Background. Data on potential variations in delivery of appropriate stroke care over time are scarce. We investigated temporal changes in the quality of acute hospital stroke care across five national audits in Europe over a period of six years. Methods. Data were derived from national stroke audits in Germany, Poland, Scotland, Sweden, and England/Wales/Northern Ireland participating within the European Implementation Score (EIS) collaboration. Temporal changes in predefined quality indicators with comparable information between the audits were investigated. Multivariable logistic regression analyses were performed to estimate adherence to quality indicators over time. Results. Between 2004 and 2009, individual data from 542,112 patients treated in 538 centers participating continuously over the study period were included. In most audits, the proportions of patients who were treated on a SU, were screened for dysphagia, and received thrombolytic treatment increased over time and ranged from 2-fold to almost 4-fold increase in patients receiving thrombolytic therapy in 2009 compared to 2004. Conclusions. A general trend towards a better quality of stroke care defined by standardized quality indicators was observed over time. The association between introducing a specific measure and higher adherence over time might indicate that monitoring of stroke care performance contributes to improving quality of care. 2015 BioMed Research International 2015 432497 urn:nbn:de:bvb:20-opus-149059 10.1155/2015/432497 Institut für Klinische Epidemiologie und Biometrie OPUS4-14866 Wissenschaftlicher Artikel Wiedmann, Silke; Heuschmann, Peter U.; Hermanek, Peter In reply: The quality of acute stroke treatment-an analysis of evidence-based indicators in 260 000 patients No abstract available. 2015 288 Deutsches Aerzteblatt International 112 urn:nbn:de:bvb:20-opus-148666 10.3238/arztebl.2015.0288b Institut für Klinische Epidemiologie und Biometrie OPUS4-11474 Wissenschaftlicher Artikel Wiedmann, Silke; Heuschmann, Peter U.; Hillmann, Steffi; Busse, Otto; Wiethoelter, Horst; Walter, Georg M.; Seidel, Guenter; Misselwitz, Bjoern; Janssen, Alfred; Berger, Klaus; Burmeister, Christoph; Matthias, Christine; Kolominsky-Rabas, Peter; Hermanek, Peter The Quality of Acute Stroke Care-an Analysis of Evidence-Based Indicators in 260 000 Patients Background: Stroke patients should be cared for in accordance with evidence-based guidelines. The extent of implementation of guidelines for the acute care of stroke patients in Germany has been unclear to date. Methods: The regional quality assurance projects that cooperate in the framework of the German Stroke Registers Study Group (Arbeitsgemeinschaft Deutscher Schlaganfall-Register, ADSR) collected data on the care of stroke patients in 627 hospitals in 2012. The quality of the acute hospital care of patients with stroke or transient ischemic attack (TIA) was assessed on the basis of 15 standardized, evidence-based quality indicators and compared across the nine participating regional quality assurance projects. Results: Data were obtained on more than 260 000 patients nationwide. Intravenous thrombolysis was performed in 59.7% of eligible ischemic stroke patients patients (range among participating projects, 49.7-63.6%). Dysphagia screening was documented in 86.2% (range, 74.8-93.1%). For the following indicators, the defined targets were not reached for all of Germany: antiaggregation within 48 hours, 93.4% (range, 86.6-96.4%); anticoagulation for atrial fibrillation, 77.6% (range, 72.4-80.1%); standardized dysphagia screening, 86.2% (range, 74.8-93.1%); oral and written information of the patients or their relatives, 86.1% (range, 75.4-91.5%). The rate of patients examined or treated by a speech therapist was in the target range. Conclusion: The defined targets were reached for most of the quality indicators. Some indicators, however, varied widely across regional quality assurance projects. This implies that the standardization of care for stroke patients in Germany has not yet been fully achieved. 2014 759-765 Deutsches Ärzteblatt International 111 45 urn:nbn:de:bvb:20-opus-114747 10.3238/arztebl.2014.0759 Institut für Klinische Epidemiologie und Biometrie OPUS4-15944 Wissenschaftlicher Artikel Hillmann, Steffi; Wiedmann, Silke; Rücker, Viktoria; Berger, Klaus; Nabavi, Darius; Bruder, Ingo; Koennecke, Hans-Christian; Seidel, Günter; Misselwitz, Björn; Janssen, Alfred; Burmeister, Christoph; Matthis, Christine; Busse, Otto; Hermanek, Peter; Heuschmann, Peter Ulrich Stroke unit care in Germany: the German stroke registers study group (ADSR) Background: Factors influencing access to stroke unit (SU) care and data on quality of SU care in Germany are scarce. We investigated characteristics of patients directly admitted to a SU as well as patient-related and structural factors influencing adherence to predefined indicators of quality of acute stroke care across hospitals providing SU care. Methods: Data were derived from the German Stroke Registers Study Group (ADSR), a voluntary network of 9 regional registers for monitoring quality of acute stroke care in Germany. Multivariable logistic regression analyses were performed to investigate characteristics influencing direct admission to SU. Generalized Linear Mixed Models (GLMM) were used to estimate the influence of structural hospital characteristics (percentage of patients admitted to SU, year of SU-certification, and number of stroke and TIA patients treated per year) on adherence to predefined quality indicators. Results: In 2012 180,887 patients were treated in 255 hospitals providing certified SU care participating within the ADSR were included in the analysis; of those 82.4% were directly admitted to a SU. Ischemic stroke patients without disturbances of consciousness (p < .0001), an interval onset to admission time ≤3 h (p < .0001), and weekend admission (p < .0001) were more likely to be directly admitted to a SU. A higher proportion of quality indicators within predefined target ranges were achieved in hospitals with a higher proportion of SU admission (p = 0.0002). Quality of stroke care could be maintained even if certification was several years ago. Conclusions: Differences in demographical and clinical characteristics regarding the probability of SU admission were observed. The influence of structural characteristics on adherence to evidence-based quality indicators was low. 2017 BMC Neurology 17 49 urn:nbn:de:bvb:20-opus-159447 10.1186/s12883-017-0819-0 Institut für Klinische Epidemiologie und Biometrie