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. 2023 Jul 19;11(14):2065.
doi: 10.3390/healthcare11142065.

Development of a Set of Indicators for Measuring and Improving Quality of Rehabilitation Care after Ischemic Stroke

Maria Cristina De Cola  1 , Augusto Ielo  1 , Francesco Corallo  1 , Sebastiano Pollina Addario  2 , Salvatore Scondotto  2 , Alessandra Allotta  2 , Giovanna Fantaci  2 , Placido Bramanti  1   3 , Rosella Ciurleo  1
Affiliations

Development of a Set of Indicators for Measuring and Improving Quality of Rehabilitation Care after Ischemic Stroke

Maria Cristina De Cola et al. Healthcare (Basel). .

Abstract

Stroke is the leading global cause of permanent disability and the second leading cause of dementia within the first year of the event. Systematic quality improvement interventions such as Audit & Feedback (A&F) can monitor and improve the performance of post-stroke care in conjunction with the use of quality indicators (QIs). The scientific literature shows limited studies on quality improvement and QIs design for poststroke rehabilitation. In Italy, the National Outcomes Evaluation Programme (PNE) annually provides several QIs concerning the acute wards. On the contrary, indicators for quality assessment of post-acute stroke rehabilitation are not available nationwide. In recent years, the Italian Ministry of Health has funded a national network project, the aim of which is to provide and evaluate the effectiveness of A&F strategies in healthcare improvement. Part of this project is the development of a set of IQs for ischemic stroke rehabilitation used to conduct an A&F. In this study, we describe the design and development process of these QIs from administrative databases and report the results of the pilot test conducted on a small sample of Sicilian rehabilitation facilities, comparing them from 2019 to 2021. Feedback from the participating centers was mainly positive, and the quality indicators were found to be comprehensible and appreciated. However, the study highlighted the need for better adherence to indicators measuring processes of rehabilitation care. The set of quality indicators presented in this study, relevant to inpatient settings, could be considered a starting point on which to base quality improvement initiatives both nationally and internationally.

Keywords: audit and feedback; care pathways; ischemic stroke; neurorehabilitation; quality indicators; rehabilitation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow of the study. Legend: WP7 = Work Package 7.
Figure 2
Figure 2
Results of pilot testing: Number of Rehabilitation Admissions.
Figure 3
Figure 3
Results of pilot testing: Results of AWTR, HD, PD, and AD indicators. Legend: AWTR = Average Waiting Time for Rehabilitation, HD = Home Discharges, PD = Protected Discharges, AD = Acute Discharges.
See this image and copyright information in PMC

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