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Chinese Stroke Center Alliance: a national effort to improve healthcare quality for acute stroke and transient ischaemic attack: rationale, design and preliminary findings
  1. Yongjun Wang1,2,3,4,5,
  2. Zixiao Li1,3,
  3. Yilong Wang1,2,
  4. Xingquan Zhao1,3,
  5. Liping Liu1,4,5,6,
  6. Xin Yang1,2,3,
  7. Caiyun Wang1,
  8. Hongqiu Gu1,2,3,
  9. Fuying Zhang7,
  10. Chunjuan Wang1,2,3,4,
  11. Ying Xian8,
  12. David Z Wang9,
  13. Qiang Dong10,
  14. Anding Xu11,
  15. Jizong Zhao1,12
  16. on behalf of Chinese Stroke Center Alliance investigators
  1. 1 China National Clinical Research Center for Neurological Diseases, Beijing, China
  2. 2 Tiantan Clinical Trial and Research Center for Stroke, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  3. 3 Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  4. 4 Center for Stroke, Beijing Institute for Brain Disorders, Beijing, China
  5. 5 Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
  6. 6 Neuro-intensive Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  7. 7 Office of Chinese Stroke Center Alliance, Chinese Stroke Association, Beijing, China
  8. 8 Department of Neurology, Duke University Medical Center, Durham, North Carolina, USA
  9. 9 INI Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria, Illinois, USA
  10. 10 Department of Neurology, Shanghai Huashan Hospital, Fudan University, Shanghai, China
  11. 11 Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China
  12. 12 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  1. Correspondence to Professor Yongjun Wang; yongjunwang1962{at}gmail.com

Abstract

Background In June 2015, the Chinese Stroke Association (CSA) initiated the Chinese Stroke Center Alliance (CSCA) to establish the national hospital-based stroke care quality assessment and improvement platform. This article outlines its objectives, operational structure, patient population, quality improvement (QI) intervention tools, data elements, data collection methodology and current patient and hospital data.

Methods The CSCA is a national, hospital-based, multicentre, voluntary, multifaceted intervention and continuous QI initiative. This multifaceted intervention includes stroke centre development, written care protocols, workshops and a monitoring/feedback system of evidence-based performance measures. The data coordinating centre of the CSCA resides at the China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital.

Results As of July 2017, 1576 hospitals in China have contributed detailed clinical information to serve as a benchmark for the stroke care quality of 433 264 patients with acute stroke/transient ischaemic attacks (TIA), including 352 572 (81.38%) acute ischaemic stroke, 30 362 (7.01%) TIA, 42 080 (9.71%) spontaneous intracranial haemorrhage, 5505 (1.27%) subarachnoid haemorrhage and 2745 (0.63%) not specified stroke.

Conclusion The CSCA programme is designed to establish a continuous national stroke registry and help healthcare providers develop stroke centres and treat patients in a consistent manner in accordance with accepted national guidelines and, ultimately, improve patient outcomes. It supports the CSA mission to reduce stroke burden in China.

  • chinese stroke center alliance
  • healthcare quality
  • acute stroke
  • transient ischemic attack

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/svn-2018-000154

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    Footnotes

    • Contributors YoW, ZL, YiW, XZ, LL, YX, DZW, QD, AX and JZZ conceived the study and oversaw all scientific aspects of its implementation. YoW, ZL and HG drafted the manuscript. HG conducted the data analysis. XY, CaW, ChW and FZ recruited hospitals and operated the CSCA programme.

    • Funding This work was supported by grants from the Ministry of Science and Technology and the Ministry of Health of the People’s Republic of China (National S & T Major Project of China: 2011BAI08B02, 2012ZX09303, 2013BAI09B14, 2013BAI09B03, 2015BAI12B02, 2015BAI12B04, 2017YFC1310900, 2017YFC1310901 and 2017YFC1310903), the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (2013BAI09B03), Beijing Municipal Committee of Science and Technology (D15110700200000, D151100002015001, D151100002015002, Z161100000516223 and Z141107002514125), Beijing Institute for Brain Disorders (BIBD-PXM2013_014226_07_000084).

    • Competing interests None declared.

    • Ethics approval Participating hospitals received either healthcare quality assessment and research approval to collect data in the CSCA project without requiring individual patient informed consent under the common rule or a waiver of authorization and exemption from subsequent review by their Institutional Review Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.

    • Collaborators Yongjun Wang, Zixiao Li, Yilong Wang, Xingquan Zhao, Liping Liu, Xin Yang, Caiyun Wang, Hongqiu Gu, Fuying Zhang, Chunjuan Wang, Ying Xian, David Wang, Qiang Dong, Anding Xu, Jizong Zhao, Kai Wang, Kai Wang, Xunming Ji, Xinyue Qin, Ning Wang, Zhaoming Ge, Jinsheng Zeng, Lvli Li, Lan Chu, Zhibin Chen, Li Guo, Guozhong Li, Yuming Xu, Bo Hu, Beisha Tang, Guorong Liu, Xiaoshan Wang, Xiaomu Wu, Yi Yang, Zhiyi He, Zhenhai Wang, Shizheng Wu, Gang Zhao, Meijia Zhu, Qiang Dong, Xiaoyuan Niu, Dong Zhou, Zhongping An, Yuhua Zhao, Xiaoning Zhang, Li Ding, Min Lou.