TY  - JOUR
A1  - Hillmann, Steffi
A1  - Wiedmann, Silke
A1  - Fraser, Alec
A1  - Baeza, Juan
A1  - Rudd, Anthony
A1  - Norrving, Bo
A1  - Asplund, Kjell
A1  - Niewada, Maciej
A1  - Dennis, Martin
A1  - Hermanek, Peter
A1  - Wolfe, Charles D. A.
A1  - Heuschmann, Peter U.
T1  - Temporal changes in the quality of acute stroke care in five national audits across Europe
JF  - BioMed Research International
N2  - 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.
KW  - ischemic stroke
KW  - indicators
KW  - thrombolysis
KW  - registries
KW  - outcomes
KW  - mortality
KW  - implementation
KW  - German Stroke Registers Study Group
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-149059
VL  - 2015
IS  - 432497
ER  - 
TY  - JOUR
A1  - Wiedmann, Silke
A1  - Heuschmann, Peter U.
A1  - Hillmann, Steffi
A1  - Busse, Otto
A1  - Wiethoelter, Horst
A1  - Walter, Georg M.
A1  - Seidel, Guenter
A1  - Misselwitz, Bjoern
A1  - Janssen, Alfred
A1  - Berger, Klaus
A1  - Burmeister, Christoph
A1  - Matthias, Christine
A1  - Kolominsky-Rabas, Peter
A1  - Hermanek, Peter
T1  - The Quality of Acute Stroke Care-an Analysis of Evidence-Based Indicators in 260 000 Patients
JF  - Deutsches Ärzteblatt International
N2  - 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.
KW  - Hesse
KW  - study-group ADSR
KW  - ischemic-stroke
KW  - Germany
KW  - implementation
KW  - rehabilitation
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-114747
SN  - 1866-0452
VL  - 111
IS  - 45
ER  -