The success of SSNAP depends on complete and timely data being submitted so that there is rapid turnaround of reporting to facilitate change.
High audit compliance is a prerequisite to ensure that the data are complete, of high data quality and produced as close to the time the patients were admitted or discharged as possible. Individual teams are provided with a weighted audit compliance score to provide a context in which to interpret their process of care results and identify areas of improvement.
The audit compliance score includes measures of high usage of “unknown” data items, in particular the elements of the NIHSS. In response to feedback from post-acute teams, some measures of speed of data entry and data transfer have been added to ensure that these teams are able to complete their sections in a timely way so that the rapid turnaround of results can be maintained.
See a full breakdown of Audit Compliance scoring below:
| Category | Contribution | Measure | Cohort |
| NIHSS at arrival | 15% | NIHSS at arrival fully complete | 72h |
| NIHSS 24h | 10% | NIHSS 24h after thrombolysis/thrombectomy is fully complete | 72h |
| Transfers | 20% | Records which are ready to transfer and have been transferred to next team | Transfer |
| Number of days from patient transferred to next team to when the record is transferred on the webtool | All teams | ||
| Patients who were recorded as discharged with either ESD or CRT in Q7.7 or Q7.8, and transferred to an ESD or CRT on the webtool | All teams | ||
| Data entry | 20% | Number of days from when patient is admitted/onset to when the record is started | 72h |
| Number of days from when the patient is discharged from the team's care to when the record is locked to discharge | Inpatient discharge | ||
| Ethnicity is known | 72h | ||
| 72h measures | 15% | Reason for no swallow screen within 4h is known | 72h |
| Reason for no swallow screen within 72h is known | 72h | ||
| Reason for no OT assessment within 72 is known | 72h | ||
| Reason for no PT assessment within 72 is known | 72h | ||
| Reason for no SALT communication assessment within 72 is known | 72h | ||
| Reason for no formal swallow assessment within 72 is known | 72h | ||
| Post-72h measures | 20% | Reason for no rehabilitation goals is known | All teams |
| Development of urinary tract infection is known | 7-day | ||
| Receipt of antibiotics for pneumonia is known | 7-day | ||
| Reason for no urinary continence plan is known | 7-day | ||
| Reason for no OT assessment by discharge is known | Inpatient discharge | ||
| Reason for no PT assessment by discharge is known | Inpatient discharge | ||
| Reason for no SALT communication assessment by discharge is known | Inpatient discharge | ||
| Reason for no SALT swallow assessment by discharge is known | Inpatient discharge | ||
| Reason for no psychologist assessment by discharge is known | Inpatient discharge | ||
| Reason for no orthoptist assessment by discharge is known | Inpatient discharge | ||
| Reason for no mood screening by discharge is known | Inpatient discharge | ||
| Reason for no cognition screening is known | Inpatient discharge | ||
| Reason for no vision screening is known | Inpatient discharge | ||
| Patients discharge home and living alone is known | Inpatient discharge | ||
| Number of social service visits is known | Inpatient discharge | ||
| Number of carer visits is known | Inpatient discharge | ||
| Number of carers is known | Inpatient discharge | ||
| Patient asked for consent by inpatient discharge | Inpatient discharge |
Tips to improve your audit compliance score
All teams
- Keep the number of 'not known' to a bare minimum
- Transfer records in advance of transfer deadlines
- Lock records as close to real-time as possible
- Communicate regularly with teams across the local care pathway to ensure a joined-up approach to SSNAP
Routinely admitting teams
- Submit all stroke patients to the audit
- Ensure NIHSS on arrival and post thrombolysis/thrombectomy is fully complete
- If transferring to another inpatient team, do not lock to discharge
Non-routinely admitting teams
- Complete and discharge or transfer all records for patients discharged within the quarter
- Chase up acute teams slow to transfer records
- If transferring to another inpatient team, do not lock to discharge
- NOTE: You are scored on audit compliance for any patients which your team directly admits (e.g. NIHSS on arrival, NIHSS 24hr post thrombolysis/thrombectomy and data entry measures) even if this only covers very small numbers of patients*.
ESD and CRT teams
- Complete and discharge or transfer all records for patients discharged within the quarter
- Chase up teams slow to transfer records
- Ensure records are locked promptly
6 month assessment providers
- Consult the guidance on finding records for 6 month assessment
- Agree local data submission procedures with teams who treat the patients you assess
- Lock data promptly for assessments provided
Any delay in a previous team transferring a record on the webtool will count against the subsequent teams, and this can negatively impact the subsequent teams' audit compliance score.
This is because "Number of days from when the patient is discharged from the team's care to when the record is locked to discharge" is calculated using the day the patient was discharged form the team and the day the patient record was locked by that team.
If the record is transferred to the team two weeks after the patient has been discharged, the team will automatically have at least a minimum 14 day delay. If an earlier team are transferring the records late, we recommend teams contact the earlier team to get them to transfer the record earlier.
A list of contacts for all teams is available to logged in users. Please go to Resources > Team Codes and Contacts and download either the Inpatient teams or Non-inpatient teams spreadsheet.
*Teams are scored for all audit compliance measures for any patients which they directly admit (for example NIHSS on arrival). For very low numbers of admissions this data has historically been suppressed. However this will be made available in team portfolios going forward.