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Audits > Clinical audit information > Domains, key indicators and scoring

Domains, key indicators and scoring

A total of 44 key indicators have been chosen by the ICSWP as representing high quality stroke care. The key indicators are grouped into 10 domains covering key aspects of stroke care. A summary listing the 10 SSNAP domains and the key indicators contained within each is available here.
SSNAP scores hospitals based on the care they provide against these key indicators and domains. Both patient-centred domain scores and team-centred domain scores are calculated. An overall SSNAP score is calculated as follows:
  • Domain levels are combined into separate patient-centred and team-centred total key indicator scores
  • A combined total key indicator score is derived from the average of these two scores
  • This combined score is adjusted for case ascertainment and audit compliance (see below)
A more detailed guide on how scores are calculated is here.

Calculating key indicators

As part of SSNAP’s efforts to ensure transparency in reporting, comprehensive guidance outlining how each of the key indicators is calculated is available to view here.
Case ascertainment and participation

In order for results to be meaningful and robust it is essential to have fully complete data on every new stroke admission. Over 90% of expected stroke hospital admissions are recorded on SSNAP by acute stroke services. These estimations are based on Hospital Episode Statistics (HES) and Patient Data Episodes in Wales (PEDW) for the previous year for hospitals in England and Wales respectively.

Methodology for calculating expected numbers 

For ‘routinely admitting teams’ (see Data analysis and methodology for definitions} to be included in SSNAP results, a minimum proportion of their expected cases must be entered on SSNAP. For ‘non-routinely admitting teams’ and ‘non-acute inpatient teams’, a proxy has been generated comparing the number of patients arriving at a team with the number of patients leaving the team. Further information on how case ascertainment is calculated is available here. It is recognised that neither method can be totally accurate which is why results are presented in bands.

In order for non-inpatient teams to receive SSNAP results, a minimum of 20 records must be entered and locked across the previous 6 month period. Case ascertainment for 6 month assessments is based on patients due for an assessment in the last 6 months, and seen by teams at any point during their inpatient stay.

Case ascertainment is included as a component in the overall SSNAP score. Results and further information on case ascertainment can be found in sheet B ‘Case Ascertainment’ of the full results portfolio. The latest results can be downloaded here

Audit compliance

Complete and timely data being submitted by clinical teams means SSNAP can turn around analysis and reporting rapidly, and thereby help facilitate change.  The ‘audit compliance’ element summarises these aspects and each team is given a score in bands. Detailed information on the components of audit compliance and how it is calculated is available here.

Results and further information on audit compliance can be found in sheet C ‘Audit Compliance’ of the full results portfolio.  The latest results can be downloaded here.

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Sentinel Stroke National Audit Programme
Kings College London
Addison House
Guy's Campus


0116 464 9901