ASC Quality Stroke Service Awards Program 2021

Recognising outstanding stroke care in Australian hospitals

The Australian Stroke Coalition (ASC) Quality Stroke Service Awards Program recognises Australian health services that achieve the highest standards for delivering quality in stroke care. In 2019, the ASC, the collective voice of stroke across multiple stakeholders, established a ‘Quality Stroke Service Awards’ Program to recognise high performing services, based on indicators related to the Acute Stroke Clinical Care Standard (Australian Commission on Safety and Quality in Health Care 2019). This is now the premier awards program for acute stroke services across Australia.

The awards recognise hospitals that achieve best-practice stroke clinical care benchmarks, such as treatment with thrombolysis within 60 minutes of hospital arrival, the provision of stroke unit care, and the provision of a discharge care plan. This National Awards Program highlights examples of best-practice stroke care for other services to learn and benefit from. In 2020, a total of seven hospitals across three states were named as Excellence Award winners. In addition, Merit Awards or Honorable Mentions were awarded to 22 hospitals.  

How does my hospital participate in this National Awards Program?

Hospitals participating in the Australian Stroke Clinical Registry (AuSCR), or Stroke Foundation’s Acute Services National Stroke Audit, will automatically be considered for the National Awards, unless they opt out.

The Stroke Foundation’s National Acute Stroke Service Audit runs every two years. If you are not participating in AuSCR, and would like to be considered for the National Awards in a non-Acute National Stroke Audit year, please contact us to arrange for the relevant data from 40 consecutive patients to be collected to enable participation.

Will my hospital also be eligible to be considered for the World Stroke Organization (WSO) Angels Awards?

The Acute Networks StrivinG for ExceLlence in Stroke (ANGELS) initiative was established in 2015 in Europe, as an industry led (Boehringer Ingelheim) collaboration, in conjunction with the European Stroke Organisation (ESO). The ANGELS initiative has since expanded, as it seeks to optimise stroke networks between individual hospitals and countries, and is now endorsed by the World Stroke Organization (WSO).

The WSO in partnership with the ANGELS initiative provides the WSO Angels Awards Program, which aims to recognise and promote best-practice in stroke care globally. The WSO Angels Awards Program was launched in Australia in 2020, with the stroke unit at Wagga Wagga Base Hospital becoming the first in Australia to receive a WSO Angels Gold Status Award.

The indicators used for the Angels Awards are similar to the National Awards, and likewise, hospitals contributing data to the AuSCR or National Stroke Audit are eligible, unless they opt out.  

Are there any differences between the National Awards and the Angels Awards, and how are they assessed?

The National Awards criteria are more comprehensive than the Angels Awards criteria and are based on our National Standards. They also incorporate a measure of quality control (minimal missing data).

The methods used to calculate both the Angels Awards and the National Awards are overseen by a subcommittee of the ASC. Analysis of the data for both awards is undertaken by an independent team, led by Associate Professor Monique Kilkenny at Monash University. The calculation methods differ for each award and more information can be found in FAQs available on the ASC website. In brief, the National Awards are based on a composite outcome derived by summarising the proportion of all eligible care opportunities that were fulfilled for the eligible group. Hospital data must also meet the threshold for completeness of data and avoidance of case selection. In contrast, the Angels Awards require a benchmark to be met for each relevant item, which is then summed in order to achieve an award status e.g. gold, platinum, or diamond (see Table 1).

The calculation of the awards is done using standardised methods. The awardees are then reviewed and endorsed by members of the ASC. This approach is consistent with the WSO Angels program for Europe and other regions. No patient-level data from hospitals are sent overseas, or are directly shared with unauthorised parties, including representatives from Boehringer Ingelheim, and the analysis team use deidentified data.

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Table 1: Award Criteria

 ASC*WSO/Angels Gold statusWSO/Angels Platinum statusWSO/Angels Diamond status
Stroke patients treated in a dedicated stroke unit (or ICU for WSO) during their hospital stayYes  Yes
% of patients treated with door to recanalization therapy time < 60 minutesYes50%75%75%
% of patients treated with door to recanalization therapy time < 45 minutesYes  50%
% recanalization procedure rate out of total stroke incidence in the hospitalYes5%15%25%
Treatment with endovascular clot retrieval within 90mins of hospital arrivalYes   
Patients mobilised on the same day or day after hospital arrival Yes   
% of all suspected stroke patients undergoing CT or MRI imaging procedure 80%85%90%
% of all stroke patients undergoing dysphagia screen 80%85%90%
% of Ischaemic stroke patients discharged with antithrombotics (antiplatelets sufficient for WSO) unless contraindicatedYes80%85%90%
% of atrial fibrillation related stroke patients discharged with anticoagulants 80%85%90%
Provision of antihypertension medication on discharge unless contraindicatedYes   
Provision of lipid-lowering medication on discharge unless contraindicatedYes   
Provision of antihypertension medication on discharge unless contraindicatedYes   
Provision of a discharge care plan (if discharged to community)Yes   

*ASC award is a composite score of included indicators. Excellence award if >80%; Merit award if >70%.