Quality Improvement in Stroke Rehabilitation: A Scoping Review

Abstract

Background: Quality improvement interventions are used extensively in health care, aiming to improve delivery and promote best practice. The impact of quality improvement interventions implemented in stroke rehabilitation remains unclear. Objective: The aim of this scoping review is to examine the different types of published quality improvement interventions in stroke rehabilitation and their impact on improving the quality of care. Materials and Methods: A scoping review was performed in the PubMed, Embase and CINAHL databases. QI studies evaluating interventions for stroke rehabilitation patients that were published up to August 2020 were included. The review looked at the types of quality improvement interventions that have been evaluated as well as the improvements/impacts reported for quality improvement interventions for stroke patients in rehabilitation. Results: We reviewed 1580 studies, twelve quality improvement interventions met inclusion criteria and were included in the current study. Six studies involved organizational change, three studies involved provider education and audit-feedback and three studies involved provider education. Of the twelve quality improvement interventions that have been included, >90% reported improvements (91.6%). In the majority of cases, improvements were noted through implementation of a myriad of interventions. Several facilitators and barriers were noted during implementation and contributed to success or failure of the intervention. Conclusion:There is paucity of full-text peer-reviewed published research investigating quality improvement interventions for improving the quality of care in stroke rehabilitation. The current review offers value to healthcare providers in terms of key success factors, contextual factors, barriers and facilitators associated with improvements in stroke rehabilitation.

Decision-maker roles in healthcare quality improvement projects: a scoping review

“…This grid aimed to capture relevant QI project characteristics and the different roles decision-makers played. We examined published systematic reviews involving QI, [34][35][36] and included fields that describe the QI projects (eg, objectives, intervention, QI framework, improvement outcome). To generate fields that met our objective and adequately reflected decision-makers' roles and engagement (eg, roles, contributions, engagement strategies, benefits of collaboration and collaboration challenges), we drew on our experience with participatory research and QI.…”

Advances in Stroke: Quality Improvement

“…Five gaps in the stroke QI literature should be addressed: studies are needed to describe QI initiatives from rural health care settings, small facilities, and underrepresented countries; parts of the continuum of care require attention: rehabilitation, 29 transitions of care, primary care, and risk factor management; studies focused on acute ischemic stroke, QI for hemorrhagic stroke and transient ischemic attack, are needed; approaches to support scalability and sustainability of QI initiatives should be evaluated; to support programs like Choosing Wisely, 30 deimplementation projects should be undertaken to reduce inappropriate care.…”

EP1 receptor: Devil in emperors coat

“…Stroke is among the major causes of death and disability in many countries and causes huge economic burdens. 57 The disease is broadly divided into ischemic and hemorrhagic stroke with ischemic stroke accounting for about 87% of strokes. 58 Spontaneous intracerebral hemorrhage (ICH) stroke is caused due to bleeding in the brain parenchyma and results in hematoma formation and damage to the brain tissue.…”

“…Stroke is among the major causes of death and disability in many countries and causes huge economic burdens 57 . The disease is broadly divided into ischemic and hemorrhagic stroke with ischemic stroke accounting for about 87% of strokes 58 .…”