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Table 2 The process indicators set

From: A cluster randomized trial to assess the impact of clinical pathways for patients with stroke: rationale and design of the Clinical Pathways for Effective and Appropriate Care Study [NCT00673491]

Indicator Measure Criterion met/expected change Source, Year
Information, advice and support from the multidisciplinary team given to the patients (and with their consent, to the carers) (%) Given to all the patients/relatives/care givers SIGN 64, 2002
Use of referral protocols (to neurovascular clinics and admission to stroke unit) (%) Given to all the patients NHS QIS (CSBS-PPI 2002) Clinical Standards, 2004; CHD/Stroke Task Force, 2001; SPREAD, 2005
Use of clinical protocols (at least 5 of the following) (%) Given to all the patients CHD/Stroke Task Force, 2001; CSBS 2002; Antiplatelet Trialists' Collaboration, 1994; SIGN 13, 1997; European Atrial Fibrillation Trial, 1993; Hebert PR, 1997; SIGN 14, 1997; Antithrombotic Trialists' Collaboration, 1998
- Stroke treatment/management protocols    
- Antiplatelet/anticoagulant protocol    
- Diabetes treatment protocol    
- Atrial fibrillation therapy protocol    
- Blood pressure lowering protocol    
- Cholesterol lowering protocol    
- Suspected carotid stenosis protocol    
- Smoking cessation protocol    
Use of (local) admission to social services protocols (%) Given to all patients Report to the Dept. of Health, 2000
Use of CT/MRI brain scan within 48 hours from admission (%) 80% SIGN 14, 1997; Wardlaw JM, 2003
Aspirin treatment within 48 hours from admission (%) Given to all patients Gubitz G (Cochrane 2003)
Swallow screen test on day of admission (%) Given to all patients SIGN 20, 1997
Blood pressure assessment (%) Given to all patients Progress, 2001; NHS QIS (CSBS 2002); Clinical Standards, 2004
ECG/ECD within 24 hours from admission (%) Given to all patients SIGN 13, 1997
Continuous monitoring within 48 hours from admission (see parameters below) (%) Differences in rates SIGN 13, 1997; New Zealand Guidelines Group, 2003; Canadian Stroke Network and the Heart and Stroke Foundation of Canada, 2006
- Blood pressure    
- Glycaemia    
- Electrolitemia    
- Breath    
Before discharge total assessment (see parameters below) (%) Given to all patients MRC/BHF Heart Protection Study, 2002, 2003; SIGN 24, 1998
- Tobacco smoke    
- Lipemia    
- Glycaemia    
Use of discharge plan (and communication) (%) Given to all the patients/relatives/care givers SIGN 24, 1998
Use of SIGN guidelines-based discharge plan (%)   SIGN 24, 1998
Use of discharge summary and information (information pack) (%)   RCPE, Consensus Panel, Nov 2000; SIGN 65, 2003