The Challenges in Meeting National Key Quality Indicators in Acute Stroke

Abstract

Background
Key Quality Indicators (KQIs) are used to evaluate the quality of acute stroke care. We aimed to benchmark these KQIs in Cavan Monaghan General Hospital (CMGH) against the national KQIs and, through a mixed-methods quantitative and qualitative survey, identify areas where improvements could be achieved.

Methods
We identified all the acute stroke calls presenting to CMGH emergency department (ED) from 01/11/2024 until 31/12/2024. We compared the KQI results with the Irish National Audit of Stroke 2023 report. The survey was deployed for completion to our medical and ED doctors.

Results
Forty-two acute stroke calls were included in the analysis with a mean age of 72.4 (SD ±14.1) and 22/42 (52%) were females. Three out of 38 (8%) patients were thrombolysed (KQI 3). Door to CT was 43min vs 51min (KQI 4) while door to thrombolysis was 82min vs 53min, for CMGH and INAS, respectively. Our mixed-method survey analysis revealed that only 11/20 (55%) of the Medical Registrars feel confident in managing acute stroke calls.

Conclusion
Analysis revealed modest KQIs for CMGH and there is need for regular training for our medical staff involved in acute stroke care that could be delivered through a national simulation-based training initiative.