Evaluation of Quality and Outcomes

The basis for improvement

The Stroke Action Plan for Europe 2018–2030 aims to raise the overall standards of care that patients can expect, in accordance with international evidence-based practice and to enable weaker services to improve.

Systematically improving the quality of stroke care can only be achieved where stroke guidelines and data is routinely collected, so that services can be audited. Data needs to be collected on the structure of stroke services (facilities, staffing etc.); the processes of care (door to needle times, intensity of rehabilitation provided, time to get to a stroke unit, etc.) and outcomes (mortality, physical, cognitive and psychological disability, frequency of complications such as pneumonia etc.).

Comprehensive guidelines need to be developed and used to set standards for clinical services. While international guidelines such as the ESO stroke guidelines can form the basis for national guidelines, these need to be adapted for use within different health systems. The guidelines should form the basis for developing audit standards.