Stroke Early Supported Discharge Team Service Evaluation Community Stroke Therapy Lead / Advanced Practitioner Occupational Therapist BSc & MSc Kirsty Jones

Overview Service Improvement And Why ? What is stroke Early Supported Discharge (ESD) Stroke pathway Methods Outcomes/Results Conclusion

Service Improvement & Why National stroke strategy 2007 NICE guidelines June 2013,Royal College of Physicians produced National Clinical guidelines for stroke 2016. Estimated 500 patients per year Target 200 per year to be treated by the ESD team (40%)

Stroke ESD The ESD team is a Multi disciplinary team ESD is a service offered to people who have suffered a new stroke, and require Stroke specific therapy at home It is a service which allows transfer of care from an inpatient environment to a primary care

Current stroke pathway Patient identified as having had a stroke Direct Admission Medical management & assessments Rehabilitation

Research Methods Aim: Evaluate whether the service is effective at improving levels of function for stroke survivors   Objectives: To evaluate if patients physical status have improved following intensive stroke therapy at home. To evaluate if patients have improved in psychological and cognitive functioning To determine the amount of contacts and minutes of therapy achieved  

Methodology & Data Analysis Mixed Method approach Sampling / Participants Satisfaction Survey – Postal Modified Rankin Scale (MRS) Thematic analysis & Descriptive approach

MRS (modified Rankin scale) on Admission from April 2016 -March 2017

MRS (modified Rankin scale) Discharge April 2016 - March 2017

Patient Satisfaction Survey “This service is invaluable and should continue” “The care and support given was lovely and has really helped with recovery” “I felt my sessions were very personalised and it was made clear what I had to do and what the benefits were” “Very professional team, who explained everything they did”

Contacts and minutes of therapy achieved

ESD Stroke ESD Home is the most appropriate environment More emphasis on psychological and social issues Involvement and empowerment of patients and carers

Conclusion There have been a range of policies introduced by the government Implementation of change Findings & Evaluation of ESD

References Creswell, J.W. (2009) Research Design: Qualitative, Quantitative, and Mixed Methods Approaches (3rd Ed). Los Angeles: Sage publications. Department of Health (2007) National Stroke Strategy. The Stationary Office London. Drummond ,A (1996) Research Methods for therapist. Chapman & Hall Fearon P, Langhorne P (2012) Early supported discharge trail lists, Services for reducing duration of hospital care for acute stroke patients. Cochrane Database Systematic Reviews 9:CD000443.

References Morse JM, (1991) Approaches to qualitative –quantitative methodological triangulation. Journal Nursing Research 40 -120-123. Royal College of Physicians (2008) National Clinical Guidelines for Stroke. London Royal College of Physicians (2016) National Clinical Guidelines for Stroke .London