STRUCTURING QUALITY STROKE REHABILITATION

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STRUCTURING QUALITY STROKE REHABILITATION

• Marisa Rose
• Acute Stroke Lead NEL Cardiac and stroke network
• Marisa.rose_at_bdpct.nhs.uk
• Sue Winnall
• Head Occupational therapist Rehabilitation
  Mile End Hospital
• Sue.winnall_at_thpct.nhs.uk

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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)

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A common story..

• Imagine again you are the person in the hospital
  that has just had a stroke..

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What does good look like

• Key aspects
• Seamless service
• Staffing
• Education training
• Patient involvement and information
• Outcome measurement

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Seamless service
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Staffing

• Specialism
• Professions
• Lines of reporting
• Rotations
• Capacity
• Collaborative working
• MDT

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Training and education

• Induction
• Stroke specific training
• Specialist staff
• Joint sessions
• Profession specific training
• Rehabilitation philosophy

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Patient involvement and information

• Family meetings
• Weekly information sessions
• Joint goal setting
• Stroke specific information
• Key worker

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Outcome measurement

• When
• How
• What
• Why

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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

Barthel Index score 20 Modified Rankin score 2
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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

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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