Measurement and Evaluation
A comprehensive evaluation system is necessary to monitor the effectiveness of the BC Stroke Strategy and measure trends and cost savings resulting from prototypes and new initiatives.
The BC Stroke Strategy recommends establishing an ongoing, system-wide network to oversee and support cooperation and coordination between health authorities in implementing, monitoring, and sustaining stroke care improvements as part of the Provincial Stroke Action Plan.
The plan was tabled with the BC Ministry of Health Services and regional Health Authorities in December 2010 for a decision around governance, funding and implementation.
The Measurement and Evaluation Working Group also worked closely with the Ministry of Health and assisted in the design of a new BC Stroke Registry, making it easier to identify stroke cases in existing administrative databases. The group has recommended changes to the way stroke cases are tracked, providing more accurate information about the patterns of stroke incidence and prevalence in B.C.
A Proposed Algorithm for Identifying Patients with Acute Cerebrovascular Syndrome is a guide to define and identify stroke cases in B.C. through Ministry of Health Services' databases.
The group has also identified five core indicators to evaluate B.C.’s progress in preventing and treating stroke. These indicators can be used to measure overall stroke care system performance:
- Reduce the proportion of patients who die in hospital or are sent to a long-term care facility after being admitted/discharged (principal diagnosis) for ischemic stroke. (If only one composite measure is used, it would be this measure of death and dependency.)
- Reduce the age-standardized incidence rate of both ischemic and hemorrhagic stroke (by 10 per cent between 2008/09 and 2013/14).
- Reduce acute care days (this includes a combination of reduced discharges and reduced average length of stay) for discharges in which an ischemic stroke is the principal diagnosis (by 10 per cent between 2008/09 and 2013/14).
- Increase the volume of TIA/non-hospitalized strokes processed in TIA Rapid Assessment Clinics (by 50 per cent between 2009/10 and 2013/14).
- Increase the number of incident ischemic stroke patients appropriately receiving tPA (to 10 per cent between 2008/09 and 2013/14).
Overall objectives in evaluation and monitoring are to:
- Design a comprehensive evaluation model that is tailored to B.C. yet is consistent with the framework for the Canadian Stroke Strategy evaluation model.
- Incorporate multidisciplinary research that allows contribution of data from multiple parties and organizations to an integrated stroke registry.
The Telestroke and TIA/Rapid Assessment prototypes have been evaluated. Download the reports here.
To download the Measurement and Evaluation Project Plan, click here.