WED 259 The challenge of mood and cognition screening in hasu

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The National Clinical guideline for stroke, recommends that services for people with stroke should provide screening for mood and cognition within six weeks of stroke using validated tools. In HASU assessing mood and cognition in a timely fashion has been challenging. In 2013 a previous audit showed cognitive screening at 48% and mood screening at only 7%. We instituted a number of measures to improve compliance including education events for MDT staff, a bespoke stroke clerking proforma, to include data collection boxes. We also introduced the briefer ‘YALE questionnaire’ for mood, and the Montreal Cognitive Assessment Tool (MOCA). We also piloted occupational therapy staff using a ‘screening sticker’ in patient notes. A daily MDT was also introduced, primarily to improve patient flow, but also to prompt action planning. Mood screening improved to 92% and cognition screening to 95% on detailed notes audit. These high compliance figures were however not fully reflected on SSNAPP although compliance has improved. SSNAP data input is completed by a single coder, non clinical staff member. We plan to employ a second data clerk and further revise the stroke proforma.

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