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Pathways to enhancing the quality of stroke care through national data monitoring systems for hospitals

Dominique A Cadilhac, Karen M Moss, Christopher J Price, Natasha A Lannin, Joyce Y K Lim and Craig S Anderson
Med J Aust 2013; 199 (10): . || doi: 10.5694/mja12.11821
Published online: 18 November 2013

Stroke care needs an integrated system for monitoring the quality of hospital care

In Australia, over 50 000 new strokes occur each year and 420 000 people live with the effects of stroke.1 All are at high risk of recurrent vascular events. Evidence exists for effective treatments to prevent stroke and subsequent disability,2 but these treatments are not universally applied, creating unwarranted clinical variation and gaps in care.3


  • 1 Translational Public Health and Evaluation Unit, Stroke and Ageing Research, Monash University, Melbourne, VIC.
  • 2 Stroke Division, The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC.
  • 3 La Trobe University, Melbourne, VIC.
  • 4 Alfred Health, Melbourne, VIC.
  • 5 Neurological and Mental Health, The George Institute for Global Health, Sydney, NSW.
  • 6 University of Sydney, Sydney, NSW.



Acknowledgements: 

This workshop was supported by the consortium organisations of the AuSCR: The George Institute for Global Health, the Florey Institute of Neuroscience and Mental Health, NSF and SSA. We thank all the participants who contributed to the workshop. The Florey Institute of Neuroscience and Mental Health acknowledges the strong support from the Victorian Government and in particular the funding from the Operational Infrastructure Support Grant. Dominique Cadilhac has a cofunded NHMRC/National Heart Foundation Fellowship. Craig Anderson has an NHMRC Fellowship.

Competing interests:

Craig Anderson was the data custodian for the AuSCR in 2011 when this workshop was undertaken and is the current chair of the AuSCR Management Committee. Dominique Cadilhac is currently the data custodian for the AuSCR and a member of the Management Committee; she is also a member of the NSF National Stroke Audit Collaborative and is responsible for overseeing the data analysis for that program. Natasha Lannin is a member of the AuSCR Management Committee. At the time of this workshop, Joyce Lim was the national project coordinator for the AuSCR, and Chris Price was on the AuSCR Management Committee as a representative of the NSF. Chris Price was the program manager for the NSF audit program until the end of 2012. Karen Moss is involved in collecting patient follow-up data for the AuSCR.

  • 1. Deloitte Access Economics. The economic impact of stroke in Australia. Sydney: Deloitte Access Economics, 2013.
  • 2. National Stroke Foundation. Clinical guidelines for stroke management 2010. Melbourne: National Stroke Foundation, 2010.
  • 3. Harris D, Cadilhac DA, Hankey GJ, et al. National Stroke Audit: the Australian Experience. Clinical Audit 2010; 2: 25-31.
  • 4. National Institute of Clinical Studies. Evidence-Practice Gaps Report Volume 1: A review of developments: 2004–2007. Canberra: National Health and Medical Research Council, 2008.
  • 5. Scobie S, Thomson R, McNeil JJ, Phillips PA. Measurement of the safety and quality of health care. Med J Aust 2006; 184 (10 Suppl): S51-S55. <MJA full text>
  • 6. Dewey HM, Thrift AG, Mihalopoulos C, et al. Cost of stroke in Australia from a societal perspective: results from the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 2001; 32: 2409-2416.
  • 7. Cadilhac DA, Lannin NA, Anderson CS, et al. Protocol and pilot data for establishing the Australian Stroke Clinical Registry. Int J Stroke 2010; 5: 217-226.
  • 8. Hubbard IJ, Harris D, Kilkenny MF, et al. Adherence to clinical guidelines improves patient outcomes in Australian audit of stroke rehabilitation practice. Arch Phys Med Rehabil 2012; 93: 965-971.
  • 9. National Stroke Foundation. StrokeLink. Melbourne: National Stroke Foundation, 2013. http://strokefoundation.com.au/health-professionals/nsf-programs/strokelink (accessed May 2013).
  • 10. Australian Stroke Coalition. Australian Stroke Coalition. Melbourne: ASC, 2013. http://australianstrokecoalition.com.au (accessed May 2013).
  • 11. Australian Council on Healthcare Standards. Australasian Clinical Indicator Report: 13th edition, 2004–2011. Sydney: ACHS, 2012.
  • 12. Cadilhac DA, Sundararajan V, Andrew N, et al. Using linked data to more comprehensively measure the quality of care for stroke - understanding the issues. Australas Epidemiol 2013; 20: 15-19

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