Lal Russell

The Sentinel Stroke National Audit Programme (SSNAP) is an established quality improvement tool for hospital-based stroke care. It is the only national stroke audit that collects data detailing stroke care beyond hospital discharge.

Like many of the national audit programmes, the stroke audit has historically focused on hospital-based care. However, in line with a move over the last decade by the NHS to develop community-based healthcare, audit programmes such as SSNAP have expanded to cover post-acute care pathways.

What has yet to be explored is the influence of such a national audit programme when focused on community-based healthcare.

This realist evaluation consists of four phases of study, each informing the next.

1. A scoping review of the literature exploring the contextual features that influence the contribution of externally initiated, multidisciplinary clinical audits to quality improvement.
2. A mixed-methods online survey investigating stakeholder experiences of SSNAP in the community setting.
3. Realist interviews exploring what influences the ability of SSNAP to contribute to quality improvement in the community setting.
4. National clinical audit data was used to explore the use, and interpretation of a patient reported outcome measure as part of quality improvement in community stroke care.

Outcomes have provided transferable insights into the role of national clinical audit in driving quality improvement in community services including the importance of organisational support, such as dedicated administrative support, leadership engagement and the fostering of audit champions in this setting. There was a recognition of the importance of accessible audit feedback to enable its strategic use and the role of collaboration-based approaches along a clinical pathway that spans organisational boundaries. Findings have informed recent changes to the Sentinel Stoke National Audit Programme and have been shared with a range of audiences and stakeholders.

Conference posters:

Russell, L., Lewis, S., Chouliara, N., James, N., Fisher, R. (2023) How can the UK’s National Stroke Audit drive quality improvement in post-hospital care? Submitted as a poster presentation to European Stroke Conference 2023. Munich.

Russell, L., Lewis, S., Chouliara, N., James, N., Fisher, R. (2023) How can prospective national audit drive quality improvement in the community setting? Submitted as a poster presentation to UK Stroke Forum 2023. Birmingham.

Russell, L., Lewis, S., Chouliara, N., James, N., Fisher, R. (2022)
How is the post-acute national stroke registry perceived by stakeholders in England and how is data currently used? Submitted as a poster presentation to World Stroke Congress 2022. Singapore

Lal gave a lightning talk about his research at our annual conference, THIS Space 2024