Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
BMJ Open Qual. 2023 Jan;12(1). doi: 10.1136/bmjoq-2022-002136.
The National Stroke Audit has been used to audit and provide feedback to health professionals and stroke care services in Australia since 2007. The Australian Stroke Clinical Registry was piloted in 2009 and numbers of hospitals participating in the registry are increasing. Considering the changing data landscape in Australia, we designed this study to evaluate the stroke audit and to inform strategic direction.
We conducted a rapid review of published literature to map features of successful data programmes, followed by a mixed-methods study, comprising national surveys and interviews with clinicians and administrators about the stroke audit. We analysed quantitative data descriptively and analysed open-ended survey responses and interview data using qualitative content analysis. We integrated data from the two sources.
We identified 47 Australian data programs, successful programs were usually funded by government sources or professional associations and typically provided twice yearly or yearly reports.106 survey participants, 14 clinician and 5 health administrator interview participants were included in the evaluation. The Stroke Audit was consistently perceived as useful for benchmarking, but there were mixed views about its value for local quality improvement. Time to enter data was the most frequently reported barrier to participation (88% of survey participants), due to the large number of datapoints and features of the audit software.Opportunities to improve the Stroke Audit included refining Audit questions, developing ways to automatically export data from electronic medical records and capturing accurate data for patients who transferred between hospitals.
While the Stroke Audit was not perceived by all users to be beneficial for traditional quality improvement purposes, the ability to benchmark national stroke services and use these data in advocacy activities was a consistently reported benefit. Modifications were suggested to improve usability and usefulness for participating sites.
自 2007 年以来，澳大利亚国家卒中审计一直用于审计和向卫生专业人员和卒中护理服务提供反馈。澳大利亚卒中临床登记处于 2009 年进行试点，参与登记处的医院数量不断增加。考虑到澳大利亚数据环境的变化，我们设计了这项研究来评估卒中审计并为战略方向提供信息。
我们对已发表的文献进行了快速回顾，以绘制成功的数据计划的特征，然后进行了一项混合方法研究，包括对临床医生和管理人员进行的全国性调查和关于卒中审计的访谈。我们对定量数据进行描述性分析，并对开放式调查答复和访谈数据进行定性内容分析。我们整合了这两个来源的数据。
我们确定了 47 个澳大利亚数据计划，成功的计划通常由政府或专业协会提供资金，通常每年提供两次或一次报告。106 名调查参与者、14 名临床医生和 5 名卫生管理员参与了评估。卒中审计被一致认为对基准测试有用，但对其对当地质量改进的价值存在不同看法。输入数据的时间是参与的最常报告的障碍（88%的调查参与者），原因是数据点数量庞大，审计软件的功能。改进卒中审计的机会包括完善审计问题、开发从电子病历自动导出数据的方法以及为在医院之间转院的患者准确捕获数据。
虽然卒中审计并非所有用户都认为对传统质量改进目的有益，但基准国家卒中服务并在宣传活动中使用这些数据的能力是一致报告的好处。建议对参与地点进行修改，以提高可用性和有用性。
