WALES CENTRE FOR HEALTH
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| Early Rehabilitation Minimum Dataset |
| |
|Early Rehab Intelligent Targets Subgroup |
|Title: Early Rehab minimum dataset |
|Authors: Michelle Price and Michelle Graham (National Leadership and Innovation Agency for Healthcare) |
|Date: 18th March 2011 |
|Version: 0c |
|Purpose of paper: To provide a structure and format for the Early Rehabilitation Intelligent Targets minimum dataset |
| |
|Recommendation: For information |
| |
Purpose of document
This document provides clear guidelines for the minimum dataset for Early Rehabilitation Intelligent Targets for 2011/12.
1 Background
Purpose of minimum dataset:
The primary purpose of a minimum dataset is to enable the same health information to be generated, independent of the system that captures it. In achieving this, it will enable healthcare professionals to measure and compare the delivery and quality of care provided and support them in sharing information with other health professionals.
This document presents a revised minimum dataset, with clear relationships between the data items proposed in the ‘How to Guide’ and the interventions specified, and a clear definition and rationale for each data item.
Minimum dataset specification
Table 1 outlines the specification for the outcome measures in order to evaluate the impact of implementing the Early Rehabilitation Driver Diagram. The table identifies the following:
• Outcome items relate to
• data item name
• definition
• rationale for collection
• data format
Table 2 outlines the minimum dataset required in order to measure compliance with the Early Rehabilitation Care Bundles. The table identifies the following:
• bundle each data item relates to
• intervention each data item relates to
• data item name
• definition
• rationale for collection
• related evidence (where applicable),
• data format
During the development of the minimum dataset, some data items were identified as process measures and are therefore not needed as part of the minimum dataset. However, they may provide valuable information on local processes and inform audit of services, so have been included in table 3 on page [13].
TABLE 1. OUTCOME MEASURES
|Outcome |Data item name |Definition |Rationale for data item |
|Date of stroke |What was the date the patient had their stroke |To calculate the delay I patients starting rehabilitation |Xx/xx/xxxx |
| | |bundles | |
|Reason for DTOC |Why was the patients transfer of care delayed | |Drop down |
| | | |Community rehabilitation services |
| | | |Social care package |
| | | |CHC funding |
| | | |Care home bed |
| | | |Aids and adaptations |
| | | |Availability of rehab beds closer |
| | | |Availability of more appropriate ward setting |
|Transfer From |Ward from which patient was transferred following acute stroke management |To enable team to identify how acute units are managing |Text |
|Transfer To |Ward where patient is receiving rehabilitation and care bundles being | |Text |
| |monitored | | |
|Discharge From |Ward where patient is receiving rehabilitation and care bundles being | |Text |
| |monitored | | |
|Discharge To |Place where patient is being discharged to |To monitor how many people are discharged home to their usual |Text |
| | |place of residence | |
|Availability of |If the patient required specialist cognitive assessment and intervention |To allow teams to monitor at the unmet demand for specialist |Yes/No |
|specialist cognitive |is it available in a timely way as clinically indicated. The specialist |cognitive assessment and intervention | |
|assessment/ intervention|assessment/ intervention may be delivered by a clinical psychologist or by| | |
| |another professional with the relevant level of competency, dependant on | | |
| |the clinical presentation. | | |
|Availability of |If the patient required specialist mood or adjustment assessment / |To allow teams to monitor at the unmet demand for specialist |Yes/No |
|specialist mood/ |intervention is it available in a timely way as clinically indicated. The |mood/ adjustment assessment and intervention | |
|adjustment assessment/ |specialist assessment/ intervention may be delivered by a clinical | | |
|intervention |psychologist, psychiatrist or by another professional with the relevant | | |
| |level of competency, dependant on the clinical presentation. | | |
|Availability of |If the patient required specialist visual assessment and intervention is |To allow teams to monitor at the unmet demand for specialist |Yes/No |
|specialist visual |it available in a timely way as clinically indicated. The specialist |visual assessment and intervention | |
|assessment/ intervention|assessment/ intervention may be delivered by an Orthoptist or by another | | |
| |professional with the relevant level of competency, dependant on the | | |
| |clinical presentation. | | |
|Availability of |If the patient required specialist continence assessment and intervention-|To allow teams to monitor at the unmet demand for specialist |Yes/No |
|specialist continence |is it available in a timely way as clinically indicated? The specialist |continence assessment and intervention | |
|assessment/ intervention|assessment/ intervention may be delivered by a Continence Clinical Nurse | | |
| |Specialist or by another professional with the relevant level of | | |
| |competency, dependant on the clinical presentation. | | |
|Data item name |Definition |Rationale |Format |
|Availability of |If the patient required specialist seating assessment and intervention- is|To allow teams to monitor at the unmet demand for specialist |Yes/No |
|specialist seating |it available in a timely way as clinically indicated? The specialist |seating assessment and intervention and equipment | |
|assessment/ equipment |assessment may be delivered by an OT or physio or by another professional | | |
| |with the relevant level of competency, dependant on the clinical | | |
| |presentation. The relevant specialist seating should also be available. | | |
|Availability of |If the patient required specialist communication assessment and |To allow teams to monitor at the unmet demand for specialist |Yes/No |
|specialist communication|intervention- is it available in a timely way as clinically indicated? The|communication assessment and intervention | |
|assessment/ intervention|specialist assessment/ intervention may be delivered by a speech and | | |
| |language therapist or by another professional with the relevant level of | | |
| |competency, dependant on the clinical presentation. | | |
|Availability of |If the patient requires specialist equipment is assessment for and |To allow teams to monitor at the unmet demand for assessment |Yes/No |
|assessment and provision|provision of the equipment available in a timely way as clinically |and provision of specialist equipment | |
|of specialist equipment |indicated? | | |
| | | | |
| |The assessment / provision of specialist equipment may be delivered by an | | |
| |Orthotist, podiatrist or by another professional with the relevant level | | |
| |of competency, dependant on the clinical presentation. | | |
|Comment box |Additional specialist assessments not available or details of specialist |This data can be interrogated to look at what additional |Text |
| |seating or equipment not available |specialists assessments or specialist equipment should be made | |
| | |available on an ad hoc basis | |
|Required number of |Based on all the stroke patients on the unit how many profession specific | |Number |
|profession specific |contacts were required in this week. |This allows teams to look at the demand for the different | |
|contacts | |professions to provide adequate levels of rehabilitation for | |
| |The core team includes; |all of the patients on the ward or unit each week | |
| |Clinical Psychology | | |
| |Dietician | | |
| |Nursing | | |
| |Occupational Therapy | | |
| |Physiotherapy | | |
| |Social Worker | | |
| |Speech and Language Therapy | | |
| | | | |
| |Contacts may be direct or indirect where the contact is related to the | | |
| |patient’s goals. | | |
| | | | |
| |Definitions of what can be included in indirect contacts should be agreed | | |
| |locally so all professional groups are doing the same. | | |
| | | | |
|Data item name |Definition |Rationale |Format |
|Delivered number of |Number of profession specific contacts delivered in that week for all |This allows teams to look at the capacity for the different |Number |
|profession specific |stroke patients on the unit- not just those in the first six weeks of |professions to provide adequate levels of rehabilitation for | |
|contacts |rehabilitation |all of the patients on the ward or unit each week | |
| | | | |
| |The core team includes; | | |
| |Clinical Psychology | | |
| |Dietician | | |
| |Nursing | | |
| |Occupational Therapy | | |
| |Physiotherapy | | |
| |Social Worker | | |
| |Speech and Language Therapy | | |
| | | | |
| |A contact is still counted as delivered if the clinician was available but| | |
| |the patient declined or was not able to participate | | |
|Comments |What were the limiting factors for not providing or exceeding the required|This allows teams to look at the impact of issues such as staff|Text |
| |levels of rehabilitation interventions |annual leave, maternity leave, sick leave on the capacity to | |
| | |deliver the required number or rehabilitation contacts | |
References
RCP – Royal College of Physicians (2008). National clinical guideline on the management of people with stroke. 3rd Edition. London. RCP Intercollegiate Stroke Working Party.
DH – Department of Health (2007). National stroke strategy. London. Department of Health
SIGN - Scottish Intercollegiate Guidelines Network (2008). Management of patients with stroke or TIA: assessment, investigation, immediate management and secondary prevention. A national clinical guideline. Edinburgh. Scottish Intercollegiate Guidelines Network
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