This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tyson, S. Articles by Turner, G. Search for Related Content PubMed PubMed Citation Articles by Tyson, S. Articles by Turner, G. Social Bookmarking                   What's this?

Discharge and follow-up for people with stroke: what happens and why

Centre for Research in Rehabilitation, Department of Health Studies, Brunel University, Isleworth, UK

Gill Turner

Southampton University Hospital Trust, Southampton, UK

Objective: To assess the quality of the process of discharge from hospital and follow-up services for people with stroke.

Design: A criterion-based process audit and basic outcome measures, combined with surveys of patients' satisfaction and staff opinion of the service.

Setting: All units treating stroke patients in a health care district including an acute and a community NHS trust, and 23 participating GP practices. Subjects: Process audit: documented notes of 98 stroke patients admitted and discharged over a four-month period. Patient satisfaction survey: 93 surviving stroke patients. Staff opinion survey: general practitioners, hospital doctors, therapists and nurses treating stroke patients throughout the district.

Results: A poor level of service was found. The main shortcomings were poor communication and liaison and a narrow focus of rehabilitation which concentrated on the assessment and provision of basic home care and activities of daily living (ADL) required to obtain discharge. There was a paucity of provision beyond this most basic level and little follow-up after discharge. Pass rates against agreed criteria were: communication between staff and patients/carers 47%, liaison between staff 44%, assessment of home-based needs 48%, assessment of domestic skills 15.5%. Fifty-one per cent of patients were referred for follow-up therapy and of these 72% started follow-up therapy within six weeks of discharge, only 27% had any follow-up assessment of activity levels and well-being. Patients were dissatisfied with the information, support services and therapy they received. The main reasons for the shortcomings were lack of awareness of the services provided, professionals' low expectations of patients' abilities, and limitations of community-based therapy services.

Conclusions: Evidence from other publications suggests that these results do not indicate a service that is any worse than other districts, rather it represents the poor deal offered to stroke patients. By comprehensively assessing several aspects of the service together this methodology has been able to reveal these inadequacies and the reasons for them.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C. A Cott and E. Finch Invited Commentary on the Movement Continuum Special Series Physical Therapy, July 1, 2007; 87(7): 925 - 926. [Full Text] [PDF]

				D. Y. Chan, C. C. Chan, and D. K. Au Motor relearning programme for stroke patients: a randomized controlled trial Clinical Rehabilitation, March 1, 2006; 20(3): 191 - 200. [Abstract] [PDF]