Acute stroke clinical care standard indicators: 4b-Rehabilitation therapy within 48 hours of initial assessment

Identifying and definitional attributes

Metadata item type:Indicator
Indicator type:Indicator
Short name:Indicator 4b-Rehabilitation therapy within 48 hours of initial assessment
METeOR identifier:627797
Registration status:Health, Candidate 14/03/2017
Description:

Proportion of patients with a final diagnosis of acute stroke who start rehabilitation therapy within 48 hours of initial assessment.

Rationale:

Patients managed in acute stroke units that offer active rehabilitation programs generally spend less time in bed and more time standing, walking and being active (Langhorne & Pollock 2002; Bernhardt et al. 2008). These units also have demonstrated good patient outcomes (Stroke Unit Trialists’ Collaboration 2013).

Indicator set:Clinical care standard indicators: acute stroke Health, Candidate 14/03/2017
Outcome area:Early rehabilitation Health, Candidate 14/03/2017

Collection and usage attributes

Computation description:

Both the numerator and the denominator include patients with a final diagnosis of acute stroke. The final diagnosis is made at the hospital where the patient is admitted for the acute phase of management of their stroke.

Both the numerator and denominator exclude stroke patients who:

  • decline rehabilitation
  • return to pre-morbid function
  • are in a coma and/or unresponsive (not simply drowsy)
  • where there are limitations of therapy (i.e. advance care directive is enacted and/or the patient is on a palliative care pathway) (Australian Stroke Coalition Rehabilitation Working Group 2012).

Presented as a percentage.

Computation:

(Numerator ÷ denominator) x 100

Numerator:

Number of patients with a final diagnosis of acute stroke who commenced rehabilitation therapy within 48 hours of initial assessment.

Denominator:

Number of patients with a final diagnosis of acute stroke separated from hospital.

Representational attributes

Representation class:Percentage
Data type:Real
Unit of measure:Episode
Format:

N[NN]

Source and reference attributes

Submitting organisation:

Australian Commission on Safety and Quality in Health Care

Reference documents:

Australian Stroke Coalition Rehabilitation Working Group 2012. Assessment for Rehabilitation: Pathway and decision-making tool. Melbourne.

Bernhardt J, Chitravas N, Meslo IL, Thrift AG & Indredavik B 2008. Not all stroke units are the same: a comparison of physical activity patterns in Melbourne, Australia, and Trondheim, Norway. Stroke 39(7): 2059–2065

Langhorne P & Pollock A 2002. What are the components of effective stroke unit care? Age and Ageing 31(5):365–371

Stroke Unit Trialists’ Collaboration 2013. Organised inpatient (stroke unit) care for stroke. Cochrane Database of Systematic Reviews Issue 9