Stroke 90:10

Stroke 90:10 is a two-year stroke improvement collaborative between hospitals in the North West Strategic Health Authority. It’s an ambitious programme that aims to significantly change frontline practice and improve stroke care. It has great potential to increase the number of people leaving hospital without a serious disability after having a stroke.  

Context

Stroke is currently the third biggest killer in the UK. We funded research [link to Bridging the quality gap] which found that we lag behind other European and Western countries in dealing with strokes. There’s a critical need for concerted effort and action in England and improving stroke services has been a national priority for the past 10 years.

What are we doing?

Stroke 90:10 aims to improve compliance with best practice from the national average of 65% to 90% by the 2010 Sentinel Stroke Audit. One pioneering intention is to make sure anyone with a suspected stroke receives a brain imaging CT scan within 24 hours. Currently, that rate stands at around 43% of people in the UK.

Teams are supported to improve systems of care to ensure patients get access to the right care in the first week after the stroke has occurred. This includes brain imaging, swallowing assessments, aspirin as appropriate and assessments by physiotherapists and occupational therapists. The hospitals have developed improvement teams, attend learning sessions and have support from a faculty team.

Teams contribute data and reports to an e-learning network where they can also access resources and teaching. We are using a stratified randomised controlled trial to evaluate the programme. Results comparing phase 1 and phase 2 sites will be available in early 2011.

Who is involved?

There are 29 hospitals within 21 trusts taking part in Stroke 90:10 (see page 2). The hospitals are divided into two groups: half joined at the start in January 2009 and half in January 2010. Maxine Power, a former Health Foundation Quality Improvement Fellow [link to QIF page], is directing the quality improvement intervention, a Breakthrough Series Collaborative.Stroke 90:10 is supported by the Health Foundation, NHS North West, the Stroke Association, the Royal College of Physicians and the Institute for Healthcare Improvement.