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

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

3. 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%)

4. 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

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

6. 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

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

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

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

10. 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”

11. Contacts and minutes of therapy achieved

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

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

14. 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:CD

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