structuring quality stroke rehabilitation
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Marisa Rose Acute Stroke Lead NEL Cardiac and stroke network [email protected] Sue Winnall Head Occupational therapist – Rehabilitation Mile End Hospital [email protected] STRUCTURING QUALITY STROKE REHABILITATION. Stroke care. Key components of organised stroke care:

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structuring quality stroke rehabilitation

Marisa Rose

Acute Stroke Lead NEL Cardiac and stroke network

[email protected]

Sue Winnall

Head Occupational therapist – Rehabilitation Mile End Hospital

[email protected]

STRUCTURING QUALITY STROKE REHABILITATION

stroke care
Stroke care
  • Key components of organised stroke care:
    • Coordinated multidisciplinary team care;
    • Staff with special interest & skills in stroke;
    • Routine involvement of carers and;
    • Continued education and training programs
        • The Stroke Unit Trialists’ Collaboration (2007)
a common story
A common story..
  • Imagine again you are the person in the hospital that has just had a stroke..
what does good look like
What does ‘good’ look like …
  • Key aspects

Seamless service

Staffing

Education & training

Patient involvement and information

Outcome measurement

staffing
Staffing
  • Specialism
  • Professions
  • Lines of reporting
  • Rotations
  • Capacity
  • Collaborative working
  • MDT
training and education
Training and education
  • Induction
  • Stroke specific training
  • Specialist staff
  • Joint sessions
  • Profession specific training
  • Rehabilitation philosophy
patient involvement and information
Patient involvement and information
  • Family meetings
  • Weekly information sessions
  • Joint goal setting
  • Stroke specific information
  • Key worker
outcome measurement
Outcome measurement
  • When
  • How
  • What
  • Why
same same
Unable to catch the bus

Cant read a bedtime story to the kids

Cant work the computer

Difficulty paying electricity bills

Difficulty using mobile phone

Not back to work

Able to do the shopping at ASDA

Able to take kids to school on the bus once a week

Back at part time employment

Same same?

Barthel Index score 20

Modified Rankin score 2

stroke measurement
Stroke measurement
  • Value for money? Quality?
    • Measuring stroke services and outcomes is challenging!
    • Process and clinical measures
    • Goal achievement is a key indicator of quality stroke service
    • Patient involvement
in summary
In summary
  • Quality stroke services can be achieved
  • Communication, team working and patient/care involvement are key
  • Measurement is essential but based on the purpose of the service
ad