Deans' stroke musings: Length of stay benchmarks for inpatient rehabilitation after stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, December 16, 2011

Length of stay benchmarks for inpatient rehabilitation after stroke

From Canada but my reading of it does not inspire confidence. I didn't see any mention of using the MRI/CT scans to identify a damage diagnosis and no mention of using direct patient outcomes.
Unless we as survivors get involved in these the end result will not be useful for our recovery(I refuse to use the term compensation).
http://informahealthcare.com/doi/abs/10.3109/09638288.2011.631681

Purpose: In Canada, no standardized benchmarks for length of stay (LOS) have been established for post-stroke inpatient rehabilitation. This paper describes the development of a severity specific median length of stay benchmarking strategy, assessment of its impact after one year of implementation in a Canadian rehabilitation hospital, and establishment of updated benchmarks that may be useful for comparison with other facilities across Canada. Method: Patient data were retrospectively assessed for all patients admitted to a single post-acute stroke rehabilitation unit in Ontario, Canada between April 2005 and March 2008. Rehabilitation Patient Groups (RPGs) were used to establish stratified median length of stay benchmarks for each group that were incorporated into team rounds beginning in October 2009. Benchmark impact was assessed using mean LOS, FIM^® gain, and discharge destination for each RPG group, collected prospectively for one year, compared against similar information from the previous calendar year. Benchmarks were then adjusted accordingly for future use. Results: Between October 2009 and September 2010, a significant reduction in average LOS was noted compared to the previous year (35.3 vs. 41.2 days; p < 0.05). Reductions in LOS were noted in each RPG group including statistically significant reductions in 4 of the 7 groups. As intended, reductions in LOS were achieved with no significant reduction in mean FIM^® gain or proportion of patients discharged home compared to the previous year. Adjusted benchmarks for LOS ranged from 13 to 48 days depending on the RPG group. Conclusions: After a single year of implementation, severity specific benchmarks helped the rehabilitation team reduce LOS while maintaining the same levels of functional gain and achieving the same rate of discharge to the community.

Implications for Rehabilitation

Efficient post-stroke rehabilitation can help to improve patient outcomes and reduce the financial burden placed on the healthcare system.
Yet, unnecessarily long lengths of stay in rehabilitation are not in the best interest of the patient and act to increase the cost of care.
This study illustrates how a length of stay benchmarking system can help to promote efficiency in post-stroke rehabilitation and reduce the cost of care without negatively impacting patient recovery.