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Stroke mortality audit using the Structured Judgement Review method

Jade Thomas1, Kyaw Lin Saw2, Katja Adie3

  • 1Royal Cornwall Hospital, Truro, UK.

Clinical Medicine (London, England)
|March 16, 2019
PubMed

Insights

Royal Cornwall Hospitals Trust stroke care review found no avoidable deaths. Improvements focus on palliative care, documentation, primary care links, and scanning facilities to address higher-than-average mortality ratios.

Area of Science:

  • Neurology
  • Healthcare Quality Improvement

Background:

  • Sentinel Stroke National Audit Programme data indicated Royal Cornwall Hospitals Trust (RCHT) had a higher than national average stroke mortality ratio.
  • RCHT stroke department initiated a mortality review utilizing the Structured Judgement Review (SJR) process to investigate these findings.

Discussion:

  • The review assessed care quality for stroke patients, finding all received adequate, good, or excellent care.
  • No patient deaths were identified as definitely avoidable, suggesting care quality was generally high.
  • Limitations of the SJR process and the review methodology were acknowledged.

Key Insights:

  • The Structured Judgement Review (SJR) is a validated tool for mortality reviews, despite identified limitations.
  • Areas for improvement include enhancing compliance with palliative care guidelines, improving patient record documentation, and strengthening primary care integration.
  • Consideration should be given to upgrading diagnostic scanning facilities.

Outlook:

  • Further investigation into unaccounted factors influencing stroke mortality is warranted.
  • Implementing proposed improvements may help address perceived mortality ratios and enhance stroke patient outcomes.
  • Continued monitoring and quality improvement initiatives are essential for stroke services.

Keywords:
Strokemortalitymortality reviewstroke carestructured judgement review

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