HUS (Helsinki University Hospital) Neurocenter adopted BCB Medical’s quality register in 2015. The Helsinki Stroke Quality Register (HSQR) comprises all stroke patients admitted as neurologic patients to the HUS Emergency Department. The benefits of HSQR are significant: adding and analysing data is easier and more reliable, the data is more homogeneous, and the register is a valuable tool for clinical research.
The HSQR register contains data on patient demographics, premorbid cardiovascular diseases and medication, time stamps of symptom onset, admission, details and timestamps about endovascular thrombectomy, and administration of intravenous thrombolysis (IVT), imaging results, baseline National Institutes of Stroke Scale (NIHSS) score, and clinical outcome at three months.
“We have had some form of register since 1995 when we first started treating acute ischemic stroke patients with intravenous thrombolysis,“ says Head Physician Sami Curtze at HUS Neurocenter.
“In the early days, patient data was recorded on paper and eventually transferred to an Excel sheet. Today, we can swiftly record the data on our tablets by the patient’s bedside directly into the HSQR register.”
HSQR was introduced in 2015, but the planning phase started two years earlier. The update from an Excel-based register to a more advanced system became relevant as the amount of data to be recorded increased and technology developed.
Valuable parameters for evaluating quality of care
The main goal of both the earlier register and HSQR was to record and document the recovery of patients treated. Both contained complication rates, NIHSS scores, delays and duration of treatment, recoveries, and other relevant data.
“For instance, the door-to-needle-time (DTN) is a convenient parameter when we want to evaluate the quality of treatment: if we can reduce the delay, our clinical pathway is effective.”
Reductions in stroke thrombolysis and thrombectomy delays result in health benefits for the patients. On the other hand, the cost to society of a poorer recovery for a neurological patient is significant through the need for rehabilitation, care, institutionalisation, and loss of working capacity.
Easier to analyse and detect anomalies
With the adoption of HSQR, adding data to the register became faster and more reliable. The register’s user interface reduces the possibility of human errors; for instance, multiple users can access the register simultaneously without the risk of losing or unintentionally replacing data.
“We all know that you can accidentally delete data and even whole sheets with Excel. With HSQR, patient data is always safe.”
The quality of data collected in the register is homogeneous and consistent, making it faster and easier to analyse.
“We can quickly check the overall quality of care, and if we see anomalies like spikes in complications or delayed treatment, we can make interventions and improvements in our processes and treatment pathways”, Curtze says.
Useful tool for research
As a university hospital, HUS is obligated to carry out clinical studies. HSQR makes recruiting and pre-screening potential patients easier. The register also serves as a database for registry studies and a tool for aetiological investigations.
Thanks to ongoing research, the criteria for treating a stroke are constantly evolving. The quality register ensures that the latest medical advancements are used and carefully documented, benefiting current and future patients alike.
“Since the adoption of HSQR, we have regularly started to inform our personnel of the key parameters we can easily produce from the register data, like the number of patients, treatment, delays, and duration. This is important for the professional development of our staff, especially when it comes to new therapies: has the treatment been effective, and how have the patients fared?”
Stroke quality registers are also used in other wellbeing services counties in Finland. Thanks to the registers, the data content is uniform across all hospitals, enabling national comparability.
