Audit of Mood Assessment Post Stroke At a University Hospital

Abstract Background Post-stroke mood disturbances are common, negatively impact recovery and quality of life and are amenable to treatment. The National Clinical Guidelines for Stroke 2023 recommended the routine assessment of mood as an essential component of comprehensive stroke management. A quality improvement (QI) project was initiated to standardise mood screening in 2022 at a university teaching hospital. Consensus was reached on a shared multidisciplinary team-based model for the implementation of the SODS (S: Sadness, O: Outlook, D: Decision-making, S: Sleep) mood screening tool, incorporating routine verification of mood screening completion at the weekly multidisciplinary team meeting. Patients screening positive were referred for psychological assessment. This audit aimed to evaluate the longer term impact on mood screening in the subsequent years 2023-2024. Methods This was a retrospective audit reviewing stroke admissions from 2022-2024 using data extracted from the HIPE database and Institutional Stroke Portal. All patients admitted with a confirmed diagnosis of stroke were included. Data collected included demographics, outcomes, and mood assessment completion. Descriptive analysis was conducted. Results A total of 1,624 stroke cases were reviewed: 512 in 2022, 561 in 2023, and 551 in 2024. Mood assessment completion rates were 71.7% (367/512) in 2022, 75.9% (426/561) in 2023, and 84.0% (463/551) in 2024. This is benchmarked to a mood screening rate of 34% nationally (2023). Conclusion This audit demonstrated a progressive improvement in mood assessment compliance following implementation of a QI project in 2022, highlighting the sustainability of such an initiative when supported by the multidisciplinary team and psychology resource. Other QI interventions could benefit from extending beyond educational initiatives to include elements such as process changes and protocols supported by multidisciplinary engagement and participation.