5.1 Percentage of applicable patients who are assessed by a nurse within 4 hours AND OT and PT within 24 hours AND SLT within 72 hours AND have rehab goals agreed within 5 days (Therapy intensity d...

This Key Indicator can be broken down into four components

1. assessment by a nurse within 4 hours
2. assessment by occupational therapist and physiotherapist within 24 hours
3. assessment by speech and language therapist within 72 hours
4. have rehabilitation goals agreed within 5 days

Patients included if eligible for all four components:

1. as in Key Indicator 1.6 (all patients)
2. all patients are included except those who are either medically unwell, refused to be assessed or had no relevant deficit
3. all patients are included except those who are either medically unwell, refused to be assessed or had no relevant deficit
4. All patients are including except those who refused rehab goals, have no impairments, medically unwell for entire admission OR decided palliative at any stage.

Patients must be eligible for all four parts to be deemed eligible for this Key Indicator

Excluded: 

1. no patients are excluded
2. patients who either refused, are medically unwell, or had no relevant deficit for all three therapies
3. patients who either refused, are medically unwell, or had no relevant deficit for all three therapies
4. patients who refused, have no impairments or are medically unwell for the entire admission are excluded. Patients where it has been decided either in the first 72 hours or by discharge that the patient is for palliative care are also excluded.

Numerator = the number of patients who achieve all 4 components of the indicator.

Denominator = all the applicable patients in the cohort. Patients who are applicable for all four components but did not achieve all four components are included in the denominator.

To calculate the numerator:

Part 1)

For newly arrived patients, the difference between the date and time of assessment by stroke nurse (Q 3.2) and date and time of arrival (Q 1.13) must be greater than or equal to 0 minutes and less than or equal to 240 minutes.

For patients already in hospital at the time of their stroke (Q 1.10 is ‘Yes’), the difference between the date and time of assessment by stroke nurse (Q 3.2) and the date and time of symptom onset (Q 1.11) must be greater or equal to 0 minutes and less than or equal to 240 minutes.

AND

Part 2)

For newly arrived patients, the difference between the date and time first assessed by an occupational therapist and a physiotherapist (Q 3.5, 3.6) if required, and the date of arrival (Q 1.13) must be greater than 0 minutes and less than or equal to 1440 minutes.

For patients already in hospital at the time of their stroke (Q 1.10 is ‘Yes’), the difference between the date and time first assessed by an occupational therapist and a physiotherapist (Q 3.5, 3.6) if required, and the date of symptom onset (Q 1.11) must be greater than 0 minutes and less than or equal to 1440 minutes.

If a patient is only applicable to be assessed by either a physiotherapist or an occupational therapist, part 2 will only consider the applicable therapy assessment.

AND

Part 3)

For newly arrived patients, the difference between the date and time communication first assessed by speech and language therapist (Q 3.7) and the date of arrival (Q 1.13) must be greater than 0 minutes and less than or equal to 4320 minutes.

For patients already in hospital at the time of their stroke (Q 1.10 is ‘Yes’), difference between the date and time communication first assessed by speech and language therapist (Q 3.7) (Q 3.7) and the date of symptom onset (Q 1.11) must be greater than 0 minutes and less than or equal to 4320 minutes.

AND

Part 4)

For newly arrived patients, the difference between the first date rehabilitation goals agreed (Q 6.10) and the date of arrival (Q 1.13) must be greater than or equal to 0 days and less than or equal to 5 days.

For patients already in hospital at the time of their stroke (Q 1.10 is ‘Yes’), the difference between first date rehabilitation goals agreed (Q 6.10) and the date of symptom onset (Q 1.11) must be greater or equal to 0 days and less than or equal to 5 days.

For team centred	For patient centred
N/A	All patients eligible in the patient-centred post-72hr cohort