CLINICAL AND ORGANIZATIONAL QUALITY INDICATORS IN THE ACUTE PHASE FOR OPTIMAL STROKE MANAGEMENT IN ADULTS: A SCOPING REVIEW

Optimal interdisciplinary care and services for stroke patients and their caregivers are critical factors in recovery and quality of life following the initial event. In order to measure current practices in organizations, several indicators have been developed and are used to monitor quality of care for people who had a stroke. However, few studies have been conducted on the identification and the measurement of these indicators in the stroke acute phase. The purpose of this scoping review is to identify clinical and organizational indicators relevant to monitor quality of post-stroke care during this important phase for patients, family caregivers, health professionals and managers.

A scoping review based on the 6 steps of Arskey and O'Malley methodological framework was conducted in electronic databases (Medline, CINHAL, EBSCO, Cochrane Library, Google Scholar and Google). Grey literature and all scientific studies conducted and published between 2015 and 2021, in French and English, have been selected based on inclusion criteria. A second independent reviewer participated in study selection and data extraction. All identified indicators have been classified to measure concepts of care performance (accessibility, equity of access, efficiency, safety, patient and family responsiveness, continuity of care, efficiency and viability). A final list of indicators will be revised by a panel of clinical and scientific experts using a Delphi process. These experts will give their opinion on the relevance, validity, reliability, feasibility, usability and comparability of the identified indicators. A total of 3562 references has been identified. Of these, 25 were included in the review, but only 8 of them are research studies. A total of 242 indicators have been identified. Most of them are from grey literature and guidelines. Majority of the indicators have been classified according to the concept of safety and relate to the management of stroke complications. Few indicators relate to the concepts of equity of care and patient responsiveness.

This scoping review highlights clinical and organizational indicators that should be monitored to improve stroke management and clinical practice in the acute phase. It also justifies the need to conduct further studies to improve the measurement of quality indicators in clinical practice during this key phase of the stroke trajectory.