Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Thursday, August 4, 2016

Hospitals aren’t considering patient-reported outcomes yet, but they know they will have to

When you get these questionnaires post stroke discharge you will have to be brutally honest and report on the failures your hospital had in not getting you to 100% recovery. Be specific. Had 20 therapy sessions on hand/finger movement, still no use of hand/fingers. Spasticity set in and was not treated. Walking .is only possible with an AFO and cane. Aphasia is still causing major problems with communication. Fatigue is constant, I have fuzzy brain and cognitive issues. The goal is 100% recovery. That is non-negotiable regardless of the protestations of your medical staff.
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/ Aug 3, 2016 at 9:45 AM

Hospitals are just starting to come to grips with the reality that they must pay attention to patient-reported outcomes, but they have a lot of catching up to do.
Just 18 percent of hospitals always consult patient-reported outcomes when making clinical decisions and setting care guidelines, according to a survey of hospital executives, conducted by Salt Lake City-based analytics firm Health Catalyst. Still, that is a higher rate than some expected.
“I was actually surprised that 18 percent were actually using it all the time,” said Dr. Caleb Stowell, vice president of standardization and business development for the International Consortium for Health Outcomes Measurement (ICHOM). ICHOM, of Cambridge, Massachusetts, helps set standards for reporting on health outcomes. The organization did not participate in the survey, but does work with Health Catalyst.
Still, 72 percent of hospitals that said they “rarely” or “never” consider patient-reported outcomes indicated that they intend to start doing so regularly in the next 1-3 years as healthcare moves from fee-for-service to value-based payment. Of the need to embrace value-based care, Stowell said, “We’ve sold it.”
Patient-reported outcomes seem to be the next horizon in quality reporting and scoring. To date, reports on outcomes and patient safety have mostly indicated whether a hospital has harmed individuals, not how patients perceive care or whether treatment improved their quality of life.
Patient-reported outcomes have long been prevalent in research and clinical trials. In clinical care, however, there have only been “fairly rudimentary applications so far,” Stowell said.
That is changing. Notably, the Centers for Medicare and Medicaid Services already incorporates patient-reported outcomes into its value-based payment program for knee and hip replacements, though reporting is voluntary for now. But the Merit-based Incentive Payment System (MIPS), which is scheduled to take effect in 2019, will consider patient-reported outcomes in the calculation of Medicare payments to physicians.
“It will be a journey,” Stowell said. “But I think most people see this as the writing on the wall,” Stowell said.

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