Pre-hospital specialist triage of potential stroke patients using digital technology

A rapid service evaluation to capture learning and impact of innovations prompted by the COVID-19 pandemic.


Published: 01/08/2020

Project status: Ongoing

This is a RSET project (Rapid Service Evaluation Team), a collaboration between the Nuffield Trust and UCL and funded by NIHR.

Clinical leaders in North Central London and East Kent have asked NIHR RSET to evaluate new digital systems which allow stroke specialists to examine and prioritise (‘triage’) potential stroke patients before they reach hospital. These new systems are being piloted by stroke specialists and ambulance services in response to the COVID-19 pandemic.

Working with local stroke and ambulance services, NIHR RSET will conduct a rapid mixed method service evaluation. The evaluation will include a rapid scoping review of available evidence on remote pre-hospital triage for potential stroke patients using digital technologies, with a particular focus on implementation factors and how technology may assist real-time clinical decision making. It will also include analyses of remote triage systems that are being piloted in two areas: North Central London and East Kent. We will use qualitative data (documents, interviews, and meeting observations) and quantitative data (locally collected measures and national audit data) to analyse the perceived usability, acceptability, and safety of the new triage systems, and their impact on care delivery.

The lessons generated through this evaluation will be of use to service planners and stroke and ambulance services. Locally, lessons will inform decisions about potential further implementation of remote triage systems for stroke across London and the South East Coast. Nationally, they may influence the pre-hospital workstream for delivery of the NHS Long Term Plan. Finally, this work will potentially lead to development of a larger research proposal.

Full study protocol for this evaluation

Project team
  • Angus Ramsay
  • Jean Ledger
  • Sonila M Tomini
  • Naomi Fulop

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