OBJECTIVES: To describe the standards of care for @entity64 @entity1 in England, Wales and Northern Ireland and to determine the power of national audit, coupled with an active dissemination strategy to effect change. DESIGN: A national audit of organisational structure and retrospective case note audit, repeated within 18 months. Separate postal questionnaires were used to identify the types of change made between the first and second round and to compare the representativeness of the samples. SETTING: 157 trusts (64% of eligible trusts in England, Wales, and Northern Ireland) participated in both rounds. @entity1 : 5589 consecutive @entity1 admitted with @entity64 between 1 January 1998 and 31 March 1998 (up to 40 per trust) and 5375 @entity1 admitted between 1 August 1999 and 31 October 1999 (up to 40 per trust). Audit tool-Royal College of Physicians Intercollegiate Working @entity64 audit. RESULTS: The proportion of @entity1 managed on @entity64 units rose between the two audits from 19% to 26% with the proportion managed on general wards falling from 60% to 55% and those managed on general rehabilitation wards falling from 14% to 11%. Standards of assessment, rehabilitation, and discharge planning improved equally on @entity64 units and general wards, but in many aspects remained poor (41% formal cognitive assessment, 46% weighed once during admission, 67% physiotherapy assessment within 72 hours, 24% plan documented for @entity1316 , 36% carers' needs assessed separately). CONCLUSIONS: Nationally conducted audit linked to a comprehensive dissemination programme was effective in stimulating improvements in the quality of care for @entity1 with @entity64 . More @entity1 are being managed on @entity64 units and multidisciplinary care is becoming more widespread. There remain, however, many areas where standards of care are low, indicating a need for investment of skills and resources to achieve acceptable levels.

National XXXX audit: a tool for change?

@entity1 :: ('9606', 'Species') :: ['patients', 'PARTICIPANTS'] @entity1316 :: ('MESH:D019964', 'Disease') :: ['mood disturbance'] @entity64 :: ('MESH:D020521', 'Disease') :: ['Party stroke', 'stroke']
@entity64 :: (MESH:D020521,Disease) :: ['stroke']
