Included: all patients are included in this indicator, except those who went directly to ITU/CCU/HDU during their stay in hospital, those who received thrombectomy, those who were referred for a thrombectomy and those who died on the same day as arrival/onset of symptoms.
Excluded: patients who were admitted to ITU/CCU/HDU, those who received thrombectomy, those who were referred for a thrombectomy and those who died on the same day as arrival/onset of symptoms are excluded from this indicator
Numerator = patients who spent at least 90% of their stay on a stroke unit.
Denominator = all patients in the cohort (apart from the patients who were admitted to ITU/CCU/HDU and those who received thrombectomy and those who were referred for a thrombectomy and those who died on the same day as arrival/onset of symptoms).
To calculate the number of patients who spent at least 90% of their stay on a stroke unit, the length of stay must first be calculated.
The length of stay is calculated as the difference between the date and time of discharge/death and either date and time of arrival for newly arrived patients or onset of symptoms for inpatient strokes.
To identify date and time of discharge/death for patients:
who were discharged alive, use:
- Q 7.3 Date and time of discharge/ transfer from team
who died on a stroke unit (Q 7.1.2 is Yes), use:
- Q 7.1.1 What was the date of death? with an assumed time component of 23:59
who died in hospital but not on a stroke unit (Q 7.1.2 is “No”) and were discharged from the stroke unit on the same day as death (Q 7.2 and Q 7.1.1 is the same date), use:
- Q 7.2 Date and time of discharge from stroke unit
who died in hospital but not on a stroke unit either because they were not admitted to a stroke unit at that team (Q 4.3 is Did not stay on a stroke unit) or because they were discharged from the stroke unit before the date of death (Q 7.1.2 is “No” and Q 7.2 is before Q 7.1.1), use:
- Q 7.1.1 What was the date of death? with an assumed time component of 00:00
who were transferred to another inpatient team (Q 7.1 is “Was transferred to another inpatient care team”), use:
- Q 7.3 Date and time of discharge/ transfer from team
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For team centred |
For patient centred |
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The length of stay at each team is the difference between the date and time of team discharge/death as calculated above and either the date and time patient arrived at this hospital team (Q4.1), or the date and time of symptom onset (Q1.11) for patients already in hospital (Q1.11 is only used for the first team). |
The length of stay across the whole inpatient stay if the difference between the date and time of final inpatient discharge for each patient and either date and time of arrival (Q1.13), or date and time of symptom onset (Q1.11) for patients already in hospital. |
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4 hours if then taken away from the length of stay, as this makes the inclusion of patients with short lengths of stay feasible for this indicator. |
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Next, the length of stay on a stroke unit must be calculated.
To identify the length of stay on a stroke unit for patients:
discharged/transferred alive:
- the length of stay on a stroke unit is the difference between Q 4.3 (the date and time the patient arrived on stroke unit at this hospital) and Q 7.2 (date and time of discharge from stroke unit)
who die on a stroke unit (Q 7.1.2 is “Yes”):
- the length of stay on a stroke unit is the difference between Q 4.3 (date and time the patient arrived on stroke unit at this hospital) and the date component given in Q 7.1.1 (What was the date of death?) with a time component of 23:59
who die in hospital but not on a stroke unit (Q 7.1.2 is “No”):
- the length of stay on a stroke unit is the difference between Q 4.3 (date and time the patient arrived on stroke unit at this hospital) and Q7.2 (date and time of discharge from stroke unit)
who did not stay on a stroke unit at a given team (Q 4.3 is “Did not stay on a stroke unit”):
- the length of stay on the stroke unit is 0 min
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For team centred |
For patient centred |
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As calculated above |
overall length of stay is calculated by adding length of stay on the stroke unit per team as calculated above |
To calculate the percentage of a patient’s stay on a stroke unit:
If the percentage of a patient’s stay on a stroke unit is greater than or equal to 90% the patient has achieved this indicator.
If the patient’s length of stay on the stroke unit is less than 4 hours and the patient went to the stroke unit at any time during those 4 hours, the patient is counted as having achieved the indicator.