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STRUCTURING QUALITY STROKE REHABILITATION

Marisa Rose Acute Stroke Lead NEL Cardiac and stroke network Marisa.rose@bdpct.nhs.uk Sue Winnall Head Occupational therapist – Rehabilitation Mile End Hospital Sue.winnall@thpct.nhs.uk. STRUCTURING QUALITY STROKE REHABILITATION. Stroke care. Key components of organised stroke care:

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STRUCTURING QUALITY STROKE REHABILITATION

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  1. Marisa Rose Acute Stroke Lead NEL Cardiac and stroke network Marisa.rose@bdpct.nhs.uk Sue Winnall Head Occupational therapist – Rehabilitation Mile End Hospital Sue.winnall@thpct.nhs.uk STRUCTURING QUALITY STROKE REHABILITATION

  2. 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)

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

  4. What does ‘good’ look like … • Key aspects Seamless service Staffing Education & training Patient involvement and information Outcome measurement

  5. Seamless service

  6. Staffing • Specialism • Professions • Lines of reporting • Rotations • Capacity • Collaborative working • MDT

  7. Training and education • Induction • Stroke specific training • Specialist staff • Joint sessions • Profession specific training • Rehabilitation philosophy

  8. Patient involvement and information • Family meetings • Weekly information sessions • Joint goal setting • Stroke specific information • Key worker

  9. Outcome measurement • When • How • What • Why

  10. 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

  11. 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

  12. 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

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