TPMI Research Day Oct 8 2015 Cassie Chisholm

Stroke: What are the gaps in quality of early care and what is their

Quality of Stroke Care – Why? Is there a problem? TPMI Qo. C Research

2012 Stroke Admission Rates (Technical Services Report) 169 180 160 140 159 140 139

Stroke Mortality per 100 K population from 2014 Technical Report 40 35 34. 3

Quality of Stroke Care • Yes we have a problem • To solve the

Objectives • Examine local management of adults presenting with stroke or transient ischemic attack

Objectives • Determine the relationship between gaps in key components of care and patient

Quality of Stroke Care How? • Isolate key care components of interest – a

Timeline • • • Complete coursework 2015 -2016 Data collection/acquisition: Fall 2015 and ongoing

Slides: 10

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TPMI Research Day Oct 8, 2015 Cassie Chisholm BSc. Physiotherapy

Stroke: What are the gaps in quality of early care and what is their relationship to health resource utilization and patient outcomes? First Semester- Master of Science, Clinical Epidemiology Supervisory Committee • Dr. Pat Parfrey • Dr. Michelle Ploughman • Dr. Elizabeth Dicks • Dr. Jason Mc. Carthy TPMI Qo. C Research Day Oct 8, 2015

Quality of Stroke Care – Why? Is there a problem? TPMI Qo. C Research Day Oct 8, 2015

2012 Stroke Admission Rates (Technical Services Report) 169 180 160 140 159 140 139 120 100 80 60 40 20 0 Standardized Stroke Admission Rates Canada Crude Stroke Admission Rates NL

Stroke Mortality per 100 K population from 2014 Technical Report 40 35 34. 3 29. 6 30 25 23. 3 20. 9 18 20 13. 5 15 10 5 0 All-Cause Mortality Rate 30 -Day Stroke Mortality Rate NL Canada 7 -Day Stroke Mortality Rate

Quality of Stroke Care • Yes we have a problem • To solve the problem we need to understand the work TPMI Qo. C Research Day Oct 8, 2015

Objectives • Examine local management of adults presenting with stroke or transient ischemic attack (TIA) in comparison to ‘standard of care’ • Understand processes in care, turnaround times, errors, re-work Ø Access to cerebrovascular imaging Ø CT scan within 24 hours Ø Immediate vascular imaging (CT angiogram or carotid ultrasound) TPMI Qo. C Research Day Oct 8, 2015

Objectives • Determine the relationship between gaps in key components of care and patient outcome, resource utilization Ø Ø Recurrent stroke within 90 days Admission or readmission within 90 days, Length of stay Mortality TPMI Qo. C Research Day Oct 8, 2015

Quality of Stroke Care How? • Isolate key care components of interest – a blueprint • Data acquisition Ø Large data set(s), capture of multiple care encounters, potential for validation between databases using unique identifiers • Map the journey of people presenting with stroke or TIA • Compare to blueprint • Analyse relationships • Teams and partnerships TPMI Qo. C Research Day Oct 8, 2015

Timeline • • • Complete coursework 2015 -2016 Data collection/acquisition: Fall 2015 and ongoing Data analysis: May-Sept 2016 Thesis write-up: Fall 2016 Thesis submission: Feb 2017 Thank-you TPMI Qo. C Research Day Oct 8, 2015