Retrospective Analysis Of The Acute Ischemic Stroke Care Quality In A Hospital In Guangdong Province

Objects:To evaluate the quality of medical services for acute ischemic stroke from 2012 to 2016 in a county-level hospital in Guangdong Province(Kaiping Central Hospital),and to reveal the problems in the treatment of stroke in the hospital to further improve acute ischemia in Kaiping Central Hospital The quality of medical services for stroke Methods:Retrospective statistical analysis of medical records of patients with acute ischemic stroke admitted to the Department of Neurology from Kaiping Central Hospital from 2012 to 2016,statistical screening for dysphagia screening,early antithrombotic,DVT prophylaxis,rehabilitation evaluation,carotid imaging,antithrombotic,lipid-lowering drug,anticoagulation for atrial fibrillation,antihypertensive medication,antidiabetic medication,etc.The implementation of key performance index(KPI)for the quality of stroke medical services.Longitudinal comparison of the implementation of various KPIs from 2012 to 2016,horizontal comparison of the implementation of KPIs in our hospital and the National and Comprehensive Stroke Center(the First Affiliated Hospital of Jinan University)in 2016.Results: 1)Our hospital received 2025 cases of data from 2012 to 2016,including 344 cases in 2012,494 cases in 2013,443 cases in 2014,368 cases in 2015 and 358 cases in 2016.The age,sex and current medical history of each group of patients had no statistical significance(P>0.05);2)the annual KPI implementation rate of our hospital was as follows: the implementation rate of dysphagia screening from 2012 to 2016 was 86.3%,87.9%,88.3%,87.6%,87.1%;early antithrombotic treatment implementation rates were: 92.4%,93.5%,94.6%,96.9%,95.5%;DVT prevention implementation rates were: 63.8%,61.9%,59.9%,62.3%,61.5%;rehabilitation The evaluation and intervention implementation rates were: 23.8%,30.2%,35.7%,38.6%,39.7%;arterial screening and evaluation implementation rates were: 79.9%,82.4%,80.6%,81.2%,81.8%;The implementation rates of suppository were: 90.7%,89.5%,91.6%,92.7%,90.8%;the statin lipid-lowering treatment implementation rates were: 85.5%,86.8%,89.4%,88.6%,89.7%;atrial fibrillation anticoagulation The rates were: 31.3%,28.6%,37.5%,38.9%,33.3%;the implementation rates of antihypertensive treatment for hypertension were 82.3%,80.7%,83.2%,81.7%,82.3%;The implementation rates of diabetes and hypoglycemic treatment were as follows: 83.9%,82.8%,86.6%,85.5%,88.5%;3)KPI longitudinal comparison in our hospital: except for rehabilitation evaluation and intervention indicators increased with the annual(P=0.00),others There was no statistically significant difference between the indicators in each year(p>0.05);4)Horizontal comparison of KPIs between our hospital and the country: screening for dysphagia(87.1% vs 76.5%,P=0.00),DVT prevention(61.5% vs 16.2%),P = 0.00),early anti-thrombosis(95.5% vs 86.6%,P = 0.00)and other indicators higher than the national level;rehabilitation assessment(39.7% vs 71.4%,P = 0.00)indicators lower than the national level;5)our hospital Horizontal comparison with KPI of the Comprehensive Stroke Center(the First Affiliated Hospital of Jinan University): dysphagia screening(87.1% vs 94.0%,P=0.00),DVT prevention(61.5% vs 80.8%,P=0.00),rehabilitation assessment(39.7 % vs 73.1%,P=0.00)are lower than the comprehensive stroke center.Conclusions 1,From 2012 to 2016,the service quality of acute ischemic stroke in our hospital remained relatively stable;2,There was still a gap between the KPI data we achieved as compared with that of the comprehensive stroke center.3.Our hospital should actively carry out thrombolytic treatment,strengthen the monitoring of rehabilitation evaluation and intervention,dysphagia screening,DVT prevention,atrial fibrillation anticoagulation treatment and other key performance indicators of medical service quality,implement continuous medical quality improvement,and standardize clinical treatment behavior.The gap between clinical practice and diagnosis and treatment guidelines has been continuously shortened to improve the quality of medical services for acute ischemic stroke.