Evaluating stroke care in Greater Manchester: How GM CHC is using health data to understand the challenges facing ambulance crews

Manchester icon Greater Manchester

Posted on the 4th June 2019

In Greater Manchester, approximately 48% of patients arriving at hospital via ambulance with a suspected stroke are eventually diagnosed with something other than a stroke. With conditions such as epilepsy, migraines, sepsis and Bell’s palsy often being misdiagnosed as stroke, this adds pressure on to teams working in stroke units, diverts vital resources from stroke patients and potentially delays treatment for none-stroke patients.

As part of the GM CHC stroke project, the research team are using healthcare data to identify ways in which stroke services could be improved for patients in our region. This has been done by linking North West Ambulance Service data with Salford Royal Hospital data to allow researchers to explore the care pathway for strokes and none-stroke diagnoses. The research team interviewed sixteen pre-hospital clinicians to identify the key factors which influence clinical decisions when treating a patient with a suspected stroke.

The concern surrounding potentially missing a stroke diagnosis, especially amongst certain patient cohorts, was highlighted as a key challenge by pre-hospital clinicians.  Ambulance crews also reported receiving limited feedback on a patient’s final diagnosis after taking them into hospital, reducing the opportunity to learn from each admission of a none-stroke patient to a Hyper-Acute Stroke Unit. This gap in communication, caused by factors such as pre-hospital clinicians being moved about to different hospitals between one shift and the next, prevented them from receiving feedback on their past patients.

The findings indicate that the stroke care pathway could be improved through the development of innovations and diagnostic tools to support accurate stroke recognition, increased feedback and education resources for ambulance crews and improved communication with Hyper-Acute Stroke Units.

‘Pre-hospital stroke recognition in a UK centralised stroke system: a qualitative evaluation of current practice’ was written by Lisa Brunton, Ruth Boaden, Sarah Knowles, Christopher Ashton and Adrian Parry-Jones and was published in the British Paramedic Journal.

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