Specific interventions as part of a quality improvement collaborative enhance care for ischemic stroke patients
Year: 2026
Type: article
Abstract: Introduction Adherence to guidelines for stroke care varies, despite evidence that managing fever, glycemia (sugar), and conducting swallowing screening (FeSS) reduces mortality and disability. We established a quality improvement collaborative to improve care processes for ischemic stroke, with a focus on these three recommendations. We then added two additional care process activities: screening for activities of daily living (ADL) and depression, collectively defined as FeSS + . Methods In this multicenter intervention study ( n = 24), we retrospectively analyzed 30 consecutive patient records per center of ischemic stroke patients in 2019, pre-intervention (measurement period 1 [MP1]), and in 2022, post-intervention (measurement period 2 [MP2]). All hospitals received feedback on their MP1 performance, and an optional e-learning tool on FeSS + was also offered. We compared adherence between MP1 and MP2 and assessed the impact of the e-learning tool. Results Data were collected from 580 patients during MP1 and 588 patients during MP2. E-learning tools were delivered to teams at 18 hospitals (75%). Adherence improved for temperature measurement (18 to 25%, p = 0.004) and swallowing screening (36 to 59%, p < 0.001). No significant changes were observed for glycemia, ADL, or depression screening. Improvements in adherence to glycemia management, swallowing screening, and depression screening were observed only among hospitals that disseminated the e-learning tool ( p = 0.01, <0.001, <0.001, respectively). Temperature measurement improved more in hospitals without e-learning (OR 2.62 vs. 1.27; p = 0.03). Discussion We observed improvements in measuring temperature and swallowing screening after receiving feedback. The dissemination of the e-learning tool was associated with increased adherence to glycemic measurement, swallowing screening, and depression screening, underscoring the role of specific interventions. However, overall adherence remained low, highlighting the need for continued quality improvement.
Source: Frontiers in Neurology
Authors: Charlotte Lens, Ellen Coeckelberghs, Deborah Seys, Kris Vanhaecht, Kim Bekelaar, Roel Blondia, Tom Bogaert, Laura Boutens, Joke Caudron, Romina Demontis, Sylvie De Raedt, Laurens Dobbels, Anneke Govaerts, Dimitri Hemelsoet, Marijke Huskens, Petra Olislaegers, Jean Francois Poma, Leen Sinnaeve, Charlotte Swinnen, Annelies Terwecoren, Peter Vanacker, Noa Vandevenne, Wendy Van Daele, Jens Van Elsuë, Jan Vynckier, Laetitia Yperzeele, Jelle Demeestere, Caroline Weltens, Robin Lemmens
Institutions: KU Leuven, Universitair Ziekenhuis Leuven, Ziekenhuis Oost-Limburg, Alma, AZ Sint-Blasius, Jessa Hospital, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Imelda Hospital, Ghent University Hospital, AZ Maria Middelares, AZ Sint-Maarten, AZ Sint-Jan, AZ Sint-Lucas, AZ Sint-Lucas, University of Antwerp, AZ Groeninge, Antwerp University Hospital, Sint Franciscus Gasthuis, ZNA Middelheim Hospital, St. Elisabeth Hospital, Onze Lieve Vrouwziekenhuis Hospital
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7220665096