Marisa Rose Acute Stroke Lead NEL Cardiac and stroke network Sue Winnall Head Occupational therapist – Rehabilitation Mile End Hospital

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

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

Staffing  Specialism  Professions  Lines of reporting  Rotations  Capacity  Collaborative working  MDT

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

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

 When  How  What  Why

 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

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

 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