Introduction:
In 2020 the RSN together with Agency of Clinical Innovation (ACI) Stroke Network developed NSW Realising Improvement in Stroke (RISE) to collect standardised data, review trends, benchmark and encourage quality improvement.
Methods: Data was entered into RISE by 18 RSN sites. Descriptive statistics are presented for demographic data and trends over time for clinical care data for patients with a diagnosis of stroke/TIA.
Results: Complete data sets of 7511 patients were included. 43% were female, 5% identified as Aboriginal /Torres Strait Islander, median age was 76 years (IQR 66,84), and 23% ≤ age 65. Stroke type were 65% ischaemic, 10% haemorrhagic and 24% TIA, patients took a median time of 374 minutes (IQR 118,1167) to arrive to hospital, 44% of patients presented to hospital within 4.5 hours, and 80% within 24 hours. For ischaemic stroke patients who received thrombolysis (n=470), median door-to-needle times decreased each year (2021:68minutes (IQR 56,88), 2022:63minutes (IQR 52,79), 2023:57minutes (IQR 47,74)). Stroke unit access decreased from 76% in 2021 to 72% in 2023.
Conclusion: RISE provides a comprehensive overview of stroke/TIA presentations and enables individual and collective review of trends and benchmarks, particularly useful during the challenging COVID-19 pandemic where RSN sites demonstrated high compliance with stroke key performance indicators (KPI). Achievements include exceeding the statewide stroke unit access benchmark (40%) and national door to needle target (˂60minutes). RISE allows stroke coordinators to identify trends, monitor care and act on unwarranted clinical variation to maintain high levels of compliance with Stroke National Targets.