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:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Monday, January 2, 2017

Community Stroke Rehabilitation Models in Ontario

Canadian Best Practice Recommendations for Stroke (2-3 visit/week per discipline for 8-12 weeks). If that is best practices you may as well shoot me now. So what if you end up with 36 PT visits? Survivors only care about results, not that you were able to bill 36 visits and provided care.  The whole point here is 100% survivor recovery, nothing less you fucking idiots.
Executive Summary
Post-acute stroke care in Ontario has changed dramatically over the past several years. The rising prevalence of stroke related disabilities requiring rehabilitation, and the introduction of the Canadian Best Practice Recommendations for Stroke Care, has identified a number of gaps in rehabilitation services across the province. In response to these service inequalities, a number of community and home-based stroke rehabilitation programs have been implemented. Recent changes in health care funding structures have resulted in the development of a number of additional community-based
rehabilitation models and pathways. Future models may be able to draw on the experiences and lessons learned of existing and currently emerging programs, to ensure success and enhance care for stroke patients across the province. This project was undertaken to amalgamate the knowledge and lessons learned from the development,
implementation, and successes of existing and emerging programs in an attempt to inform and guide the development of future models.
This document aims to inform health system planners, hospital and Community Care Access Centre directors, Ministry of Health and Long Term Care bodies, Local Health
Integrated Networks, and other individuals working within the stroke system, of the ongoing work of these established programs and the experiences learned from the planning and implementation of new models across the province. Through the assistance of an advisory committee of individuals working in stroke care across Ontario, resources,knowledge, and information on existing programs were brought
together to develop this resource. Program structures, elements, challenges, and successes, were examined and summarized in an effort to help inform the development, and ensure the success of, future community based stroke care models.
Four established models were identified: the South East LHINs Enhanced CCAC program, the South West LHINs Community Stroke Rehabilitation Teams, the Waterloo Wellington LHINs CCAC Stroke Program, and the Haldimand-Norfolk and Brant Community Stroke Rehabilitation Model.
Existing home-based stroke care models in Ontario have a number of similarities in programs structures, with three of the four being Community Care Access Centre (CCAC) based. All programs offer Physiotherapy, Occupational Therapy, and Speech Language Therapy as their core disciplines, with Social Work, nursing, and recreational therapy also being offered in some programs. All programs aim to meet Canadian Best
Practice Recommendations for Stroke by providing similar intensities and duration of rehabilitation services (2-3 visit/week per discipline for 8-12 weeks).
Perhaps most important is the agreement in lessons learned by these programs. The importance of program monitoring and evaluation, stroke expertise in care providers, consistent and timely communication, community partnerships, and a patient centred
focus were frequently cited as being important elements to success. (You can't have success if you don't measure results)With a number of emerging models across the province, both in the early implementation and development stages, and the inevitable development of additional future models, it is the hope that the information contained in this document will be of value in guiding and informing the success of future community and home-based stroke rehabilitation programs. 

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