Development of a learning health system for stroke in Greater Manchester (CHC Stroke) - Workstream 2: Secondary Prevention
What did we do?
We piloted the introduction of three targeted interventions in primary care designed to improve the recognition, management, and prevention of recurrent/secondary stroke following discharge from acute care. We aimed to:
Use the Performance Improvement plaN GeneratoR (PINGR) on a primary care practice system to improve awareness and monitoring of recently discharged stroke patients.
Establish a communication link and a shared set of stroke prevention targets between primary care and the Early Supportive Discharge team at Salford Royal NHS Foundation Trust.
Utilise practice-based pharmacists to develop an enhanced role in the management of patients following stroke-related discharge, to improve monitoring of Atrial Fibrillation and increase prompt treatment with appropriate medication.
We introduced each intervention in one of three GP practices within Salford.
Why is it important?
In general there is a high risk of recurrent stroke in the weeks following an initial stroke or transient ischaemic attack (TIA), most of which occur within 90 days following discharge. Between July 2015 and August 2017 there were 964 incidents of stroke in Salford alone with around 5% of these patients will experience a secondary stroke within 90 days. The three stated interventions are measures which will aim to reduce the number of recurrent strokes with a focus on treatment of hypertension and atrial fibrillation.
How did we do it?
We worked in collaboration with three local GP practices to roll out one targeted intervention per practice, testing their feasibility and proof of concept. Qualitative interviews, focus groups, and meeting observations were undertaken to support the findings of these three interventions and to identify whether they were effective measures at improving secondary stroke management in primary care.
Who did we work with?
For more information please contact Alison Littlewood (Programme Manager)