Trial reportImplementation science : IS2014
Did a quality improvement collaborative make stroke care better? A cluster randomized trial.
Trial report in Implementation science : IS, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The effectiveness of quality improvement collaboratives in improving stroke care and the facilitators and barriers to their implementation: a systematic review.Implementation science : IS · 2021Pooled it
- Implementation interventions to promote the uptake of evidence-based practices in stroke rehabilitation.The Cochrane database of systematic reviews · 2020Pooled it
- The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review.Implementation science : IS · 2020Pooled it
- The effects of care bundles on patient outcomes: a systematic review and meta-analysis.Implementation science : IS · 2017Pooled it
- Determining the sample size for a cluster-randomised trial using knowledge elicitation: Bayesian hierarchical modelling of the intracluster correlation coefficient.Clinical trials (London, England) · 2023Trial
- Improving care at scale: process evaluation of a multi-component quality improvement intervention to reduce mortality after emergency abdominal surgery (EPOCH trial).Implementation science : IS · 2018Trial
- Does a quality improvement campaign accelerate take-up of new evidence? A ten-state cluster-randomized controlled trial of the IHI's Project JOINTS.Implementation science : IS · 2017Trial
- Does public reporting influence antibiotic and injection prescribing to all patients? A cluster-randomized matched-pair trial in china.Medicine · 2016Trial
- Tailored implementation of a behaviour change intervention for post-stroke physical activity: A mixed-methods feasibility study.Clinical rehabilitation · 2025Article
- The role of QI collaboratives in neonatology.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care.Implementation science : IS · 2025Article
- Quality and reporting of large-scale improvement programmes: a review of maternity initiatives in the English NHS, 2010-2023.BMJ quality & safety · 2024Review
- Article
- Interventions for the uptake of evidence-based recommendations in acute stroke settings.The Cochrane database of systematic reviews · 2023Review
- Audit as a Tool for Improving the Quality of Stroke Care: A Review.International journal of environmental research and public health · 2023Review
- The Management and Outcome of Stroke Patients Admitted on Weekdays Compared to Weekends at the King Abdulaziz Medical City, Riyadh, Saudi Arabia.The Neurohospitalist · 2022Article
- Increasing the use of perioperative risk scoring in emergency laparotomy: nationwide quality improvement programme.BJS open · 2022Article
- Quality Improvement in Stroke Rehabilitation: A Scoping Review.Journal of multidisciplinary healthcare · 2022Article
- Effectiveness of in-service training plus the collaborative improvement strategy on the quality of routine malaria surveillance data: results of a pilot study in Kayunga District, Uganda.Malaria journal · 2021Article
- Empowering Implementation Teams with a Learning Health System Approach: Leveraging Data to Improve Quality of Care for Transient Ischemic Attack.Journal of general internal medicine · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
backgroundStroke can result in death and long-term disability. Fast and high-quality care can reduce the impact of stroke, but UK national audit data has demonstrated variability in compliance with recommended processes of care. Though quality improvement collaboratives (QICs) are widely used, whether a QIC could improve reliability of stroke care was unknown.
methodsTwenty-four NHS hospitals in the Northwest of England were randomly allocated to participate either in Stroke 90:10, a QIC based on the Breakthrough Series (BTS) model, or to a control group giving normal care. The QIC focused on nine processes of quality care for stroke already used in the national stroke audit. The nine processes were grouped into two distinct care bundles: one relating to early hours care and one relating to rehabilitation following stroke. Using an interrupted time series design and difference-in-difference analysis, we aimed to determine whether hospitals participating in the QIC improved more than the control group on bundle compliance.
resultsData were available from nine interventions (3,533 patients) and nine control hospitals (3,059 patients). Hospitals in the QIC showed a modest improvement from baseline in the odds of average compliance equivalent to a relative improvement of 10.9% (95% CI 1.3%, 20.6%) in the Early Hours Bundle and 11.2% (95% CI 1.4%, 21.5%) in the Rehabilitation Bundle. Secondary analysis suggested that some specific processes were more sensitive to an intervention effect.
conclusionsSome aspects of stroke care improved during the QIC, but the effects of the QIC were modest and further improvement is needed. The extent to which a BTS QIC can improve quality of stroke care remains uncertain. Some aspects of care may respond better to collaboratives than others.
trial registrationISRCTN13893902.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.