Authors (including presenting author) :
Wong HL(1), Chung PH(1), Lau FO(1)
Affiliation :
(1)Physiotherapy Department, Tai Po Hospital
Introduction :
A stroke database is essential to provide information for continuous quality improvement in stroke rehabilitation service. It can help service model review, clinical decision support and outcome prediction. Since April 2019, Accelerated Stroke Ambulation Program (ASAP) was started to develop in Physiotherapy Department of Tai Po Hospital (TPH). With the big data concept, a clinical prediction model of MRMI gain was built based on data in the past 8 years in TPH. Besides, to monitor the stroke outcomes and process compliance of the program, Stroke Registry, a longitudinal stroke database, was also developed and launched in October 2019. Taken the reference MRMI gain as an indicator, the Stroke Registry can monitor the progress of each stroke patient proactively. It promoted the goal-oriented approach and facilitated timely support to both junior therapists and patients.
Objectives :
1. To monitor stroke outcomes and process compliance.
2. To predict clinical outcome.
3. To give therapists a clear goal and timely clinical decision support.
Methodology :
1. The clinical prediction model of MRMI gain was developed based on TPH stroke data from 2011 to 2018 (n=4136). The correlation of reference MRMI gain and actual MRMI gain was investigated with Pearson correlation coefficient in SPSS.
2. Stroke Registry was developed with Excel to use as a database, in which formulas were set to indicate the reference MRMI gain and process compliance for prompting the therapists.
Result & Outcome :
It was found that the Pearson correlation was 0.386 which showed a moderate correlation of the reference MRMI gain and the actual MRMI gain. Besides, one-year outcome before and after the use of Stroke Registry was compared (10/2018-9/2019 Vs 10/2019-9/2020). The functional outcomes were able to keep similar (mean difference: MRMI pre 5.26, post 5.08; MFAC pre 0.73, post 0.67; BBS pre 6.62, post 6.39) with the length of training decreased by 1.39 days (mean: pre 23.17 days, post 21.78 days). Meanwhile, it was found that the staff experience of Senior Physiotherapist and Physiotherapist I reduced 9.8 years (mean: pre 22.8 years, post 13.0 years) and that of Physiotherapist II reduced 0.7 year (mean: pre 2.2 years, post 1.5 years). Functional outcomes were kept similar though staff experience much decreased. This could be explained by the success of Stroke Registry which facilitated timely support to therapists.
