Development of a learning health system for stroke in Greater Manchester – Connected Health Cities
This project aims to improve quality and timely access to care across the stroke pathway, from suspected stroke onset through to management following discharge from hospital.
Why is it important?
Over 100,000 people have a stroke in the UK every year with almost two thirds of stroke survivors leaving hospital with ongoing disability. It is crucial that those people who have had a stroke receive the correct care as quickly as possible, both during the acute phase and also after their discharge from hospital, to minimise disability and reduce the risk of further strokes.
CLAHRC GM aims to link and analyse routinely available datasets across different parts of the stroke pathway to help us to better understand the patient journey in order to identify opportunities for improvement. They will then design, implement and evaluate change in those areas identified for improvement. The project, funded by the Connected Health Cities Greater Manchester, is divided into 3 workstreams:
- Stroke mimics
Working with the North West Ambulance Service NHS Trust, CLAHRC GM aims to reduce the number of stroke mimics (people who have not had a stroke but are initially thought to have had one) from entering and progressing through the stroke pathway. This will help ensure that patients are seen by the right professionals at the right hospital as quickly as possible.
- Stroke secondary prevention
By implementing three dedicated interventions across three practice sites in Salford, we will aim to demonstrate more effective methods for monitoring and managing patients following discharge from the acute setting (with a particular focus on atrial fibrillation and blood pressure management).
1) The Early Supportive Discharge (ESD) team will produce shared guidelines for post-stroke management and establish a dedicated communication link with one of our engaged practices.
2) The PINGR system will be used in practice to automatically create alerts on practice systems when a patient is in need of management following a stroke-related discharge
3) Practice-based pharmacists at a third site will have an enhanced role in delivering post-stroke care for discharged patients
These interventions will also be supported by a dedicated training package developed by the ODN that is now available to all primary care staff in Salford.
Qualitative interviews, focus groups, and meeting observations will support the findings of these three interventions and identify whether they are effective measures at improving secondary stroke management.
- Intracerebral haemorrhage
CLARC GM is working with Health Cities to reduce death and disability in patients presenting with intracerebral haemorrhage by ensuring that they receive the correct care in the acute phase including neurosurgery where this is indicated, as quickly as possible. An App has been developed to support staff in following the care pathway indicated.