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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Quality metrics and specific quality indicators for the acute care of intracerebral haemorrhage in Hessen, Gemany

Qualitätsmessung und spezifische Qualitätsindikatoren für die Akutbehandlung der intrazerebralen Blutung in Hessen

Meeting Abstract

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  • presenting/speaker Marco Stein - Justus-Liebig Universität Gießen, Klinik für Neurochirurgie/Zentrum für Neuroonkologie, Gießen, Deutschland
  • Eberhard Uhl - Justus-Liebig Universität Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
  • Waltraud Pfeilschifter - Johann-Wolfgang Goethe Universität, Klinik für Neurologie, Frankfurt am Main, Deutschland
  • Tobias Neumann-Haefelin - Klinikum Fulda, Klinik für Neurologie, Fulda, Deutschland
  • Joachim Berkefeld - Johann-Wolfgang Goethe Universität, Institut für Neuroradiologie, Frankfurt am Main, Deutschland
  • Jens Allendörfer - Klinikum Bad Salzhausen, Klinik für Neurologie, Bad Salzhausen, Deutschland
  • Inga Sünkeler - BDH Klinik, Klinik für Neurologie, Braunfels, Deutschland
  • Björn Misselwitz - Qualitätssicherungsstelle Hessen, Eschborn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV234

doi: 10.3205/21dgnc223, urn:nbn:de:0183-21dgnc2232

Veröffentlicht: 4. Juni 2021

© 2021 Stein et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: The office of quality assurance in Hesse, Germany was established in 1995 to improve the quality of acute stoke care. Initially, quality indicators (QIs) for hospital-based care for patients with ischemic brain infarctions were developed and measured. In the last years, these QIs were partially transferred for the acute care of intracerebral hemorrhage (ICH) and new specific QIS for ICH were developed.

Methods: In 2019, 105 hospitals participated in the Hessian stroke registry. After completion of a pilot phase in 2018, we agreed on a set of nine QIs for 2019. The QIs measure outcomes (three) and processes (six). Furthermore, two new QIs were developed in 2019: Correcting INR for patients treated with vitamin K antagonists and antidote therapy for patients on new oral anticoagulants. For indicators that measure outcomes additionally ratios of observed (O) and expected rates (E) were calculated.

Results: In 2019 the following results for the QIs of all participating hospitals were observed: Neuroimaging with CT or MRI ≤30 minutes after admission [76.5% (95%CI: 73.4-79.3)], dysphagia screening [87.8% (95% CI: 85.4%-89.8%)], treatment on stroke or intensive care unit [93.8 (95% CI: 92.1%-95.0%)], physical/occupational therapy [93.2% (95% CI: 91.0-94.9)], logopaedic treatment [91.5 (95% CI: 88.7%-93.7%)], and rehabilitation for patients with relevant disabilities [86.7% (95% CI: 83.6%-89.3%)]. The overall pneumonia rate was 16.4% [Ratio O/E: 0.96 (95% CI: 0.85-1.07)]. Overall in-hospital mortality was 23.4% [Ratio O/E: 1.00 (95% CI: 0.91-1.10)]. After excluding patients with palliative settings the observed in-hospital mortality rate was 6.4% [Ratio O/E: 1.02 (95%CI: 0.80-1.28)].

Conclusion: Specific quality indicators for ICH are helpful for the monitoring stroke care quality. They create the basis for quality improvement and prioritization in acute stroke care. QIs must be designed, defined, and implemented based on current guidelines.