Supports limiting life after stroke New report
November 20, 2014
Australian stroke survivors and their families are being sent home from hospital without access to the services, support and information they need to ensure quality of life post stroke.
The National Stroke Audit Rehabilitation Services Report 2014, released today, by the National Stroke Foundation found that a lack of systems and processes to support the transition to home and for patients and carers was limiting the recovery of stroke survivors.
The Report contains results from an audit of 111 Australian hospitals including 96 public and 15 private. It measures, for the first time, hospital rehabilitation services performance against the National Rehabilitation Services Framework released in 2013. The Framework sets out nationally consistent principles, essential elements and models for best practice stroke rehabilitation care.
National Stroke Foundation Chief Executive Officer Dr Erin Lalor said by mapping care against 10 essential service elements recommended in the Framework, the Audit provided a benchmark for hospitals to build upon.
“The results were mixed with some positive performances against key elements of the Framework and others that clearly require some focused effort for improvement,’’ Dr Lalor said.
“It was pleasing to see that acute and rehabilitation teams within hospitals were working together from the outset of admission to support patients (61 percent) and the best available evidence was being used to inform good quality care (69 percent).
“We know that rehabilitation is a holistic process that should begin the first day after stroke and each stroke survivors needs vary with the aim of maximising the participation of the person with stroke in the community.
“However, the lack of systems in place to support a patients transition home and life activities were very concerning. Just 26 hospitas reported having systems for follow-up or the transfer of care once a patient went home and less than half of hospitals reported providing support and education to patients and carers in support of returning home.”
Dr Lalor said the Audit clearly highlighted areas where improvement was needed and adherence to its recomendations were expected to increase as health services became more familiar with the Framework.
“This report highlights the ongoing broad ranging needs of stroke patients. A stroke patient’s journey does not end on discharge from acute care,’’ Dr Lalor said.
“It is estimated that this year alone there will be more than 50,000 strokes in this country, this number is expected to increase to more than 132,000 by 2050. Of those who survive their stroke 65 percent will be left with a permanent disability requiring ongoing rehabilitation.
“These Framework recommendations are crucial to delivery of quality stroke care. We must ensure patients are provided with adequate access, direction and guidance to maximise their recovery and manage their return to the community.
“All Australians need and deserve access to the highest quality care no matter where they live.
“Health professionals and health services need government leadership, support and funding to develop systems and implement the Framework. To ensure nationally consistent, high quality care delivering the best possible outcome for every patient,” she said.
The National Stroke Audit Rehabilitation Services Report 2014 is a survey of 111 hospitals and 3,081 stroke patients, it represents more than 92 percent of stroke patients admitted for inpatient rehabilitation in the 12 month period of 1 January 2013 to 31 December 2013.
Participation in the Audit is voluntary and Dr Lalor thanked all those who had taken the time to participate.
“This Report will help government and health services compare their work to other rehabilitation services, assess their own performance and guide areas of quality improvement activity,’’ she said.
Nationally the report found:
The National Stroke Audit Rehabilitation Services Report 2014, released today, by the National Stroke Foundation found that a lack of systems and processes to support the transition to home and for patients and carers was limiting the recovery of stroke survivors.
The Report contains results from an audit of 111 Australian hospitals including 96 public and 15 private. It measures, for the first time, hospital rehabilitation services performance against the National Rehabilitation Services Framework released in 2013. The Framework sets out nationally consistent principles, essential elements and models for best practice stroke rehabilitation care.
National Stroke Foundation Chief Executive Officer Dr Erin Lalor said by mapping care against 10 essential service elements recommended in the Framework, the Audit provided a benchmark for hospitals to build upon.
“The results were mixed with some positive performances against key elements of the Framework and others that clearly require some focused effort for improvement,’’ Dr Lalor said.
“It was pleasing to see that acute and rehabilitation teams within hospitals were working together from the outset of admission to support patients (61 percent) and the best available evidence was being used to inform good quality care (69 percent).
“We know that rehabilitation is a holistic process that should begin the first day after stroke and each stroke survivors needs vary with the aim of maximising the participation of the person with stroke in the community.
“However, the lack of systems in place to support a patients transition home and life activities were very concerning. Just 26 hospitas reported having systems for follow-up or the transfer of care once a patient went home and less than half of hospitals reported providing support and education to patients and carers in support of returning home.”
Dr Lalor said the Audit clearly highlighted areas where improvement was needed and adherence to its recomendations were expected to increase as health services became more familiar with the Framework.
“This report highlights the ongoing broad ranging needs of stroke patients. A stroke patient’s journey does not end on discharge from acute care,’’ Dr Lalor said.
“It is estimated that this year alone there will be more than 50,000 strokes in this country, this number is expected to increase to more than 132,000 by 2050. Of those who survive their stroke 65 percent will be left with a permanent disability requiring ongoing rehabilitation.
“These Framework recommendations are crucial to delivery of quality stroke care. We must ensure patients are provided with adequate access, direction and guidance to maximise their recovery and manage their return to the community.
“All Australians need and deserve access to the highest quality care no matter where they live.
“Health professionals and health services need government leadership, support and funding to develop systems and implement the Framework. To ensure nationally consistent, high quality care delivering the best possible outcome for every patient,” she said.
The National Stroke Audit Rehabilitation Services Report 2014 is a survey of 111 hospitals and 3,081 stroke patients, it represents more than 92 percent of stroke patients admitted for inpatient rehabilitation in the 12 month period of 1 January 2013 to 31 December 2013.
Participation in the Audit is voluntary and Dr Lalor thanked all those who had taken the time to participate.
“This Report will help government and health services compare their work to other rehabilitation services, assess their own performance and guide areas of quality improvement activity,’’ she said.
Nationally the report found:
- Two hospitals surveyed adhered to all 10 elements set out in the National Rehabilitation Services Framework 2013;
- Only 43 percent of hospitals reported routinely providing support and education to carers to help in the transition home;
- Just over 10 percent of patients surveyed in the report had no documented evidence of discussing their ongoing care management plan with their care team;
- Less than one-third of stroke patients in the audit were provided with formal counselling before they returned home;
- Around 40 percent of patients with urinary incontinence returned home without a plan to manage the condition;
- Encouragingly 75 percent reported access to community based in-home rehabilitation; and
- Less than half of all stroke patients did not receive information on changing their lifestyle to avoid another stroke when they were discharged.