The performance of all Scottish hospitals in delivering stroke care is monitored against a Stroke Care Bundle, which initially in 2013 consisted of four inpatient standards i.e. timely Stroke Unit admission; swallow screen, brain imaging and aspirin administration. Thrombolysis, carotid intervention, time to specialist outpatient review and more rigorous swallowing assessment within 4 hours of admission were added in 2016.1
Prospective data on all stroke patients admitted is fed into the national Scottish Stroke Care Audit (SSCA) database. Monthly and yearly reports produced inform the Scottish Stroke Improvement Programme (SSIP).
Scottish Average Hairmyres Hospital Year
58% 77% 2013
65% 87% 2014
69% 84% 2015
61% 66% 2016
Standards are set at a level aiming to be challenging but potentially achievable by some hospitals in order to encourage improvements in performance. SSIP raises the standard once it is routinely exceeded by all hospitals. Hairmyres Hospital consistently performs well above the Scottish average in the SCB.
SSIP improves standards of stroke care year on year in Scotland. Locally, quality improvement programmes, good multidisciplinary teamwork and a degree of healthy competition are required for self-improvement.