Stroke unit care, inpatient rehabilitation and early supported discharge

Should be titled; 'Get the survivors out of our hair faster so we don't have to look at our failure to get them fully recovered'. Out of sight, out of mind.
http://www.clinmed.rcpjournal.org/content/17/2/173.short

1. Helen Rodgers, professor of stroke care^A⇑ and
2. Chris Price, senior lecturer in stroke medicine^B

+ Author Affiliations

1. ^ANewcastle University and honorary consultant stroke physician, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
2. ^BNewcastle University and honorary consultant stroke physician, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK

1. Address for correspondence: Professor Helen Rodgers, Stroke Research Group, Institute of Neuroscience, Newcastle University, 3-4 Claremont Terrace, Newcastle upon Tyne NE2 4AE, UK. Email: helen.rodgers@newcastle.ac.uk

ABSTRACT

Stroke units reduce death and disability through the provision of specialist multidisciplinary care for diagnosis, emergency treatments, normalisation of homeostasis, prevention of complications, rehabilitation and secondary prevention. All stroke patients can benefit from provision of high-quality basic medical care and some need high impact specific treatments, such as thrombolysis, that are often time dependent. A standard patient pathway should include assessment of neurological impairment, vascular risk factors, swallowing, fluid balance and nutrition, cognitive function, communication, mood disorders, continence, activities of daily living and rehabilitation goals. Good communication and shared decision making with patients and their families are key to high-quality stroke care. Patients with mild or moderate disability, who are medically stable, can continue rehabilitation at home with early supported discharge teams rather than needing a prolonged stay in hospital. National clinical guidelines and prospective audits are integral to monitoring and developing stroke services in the UK.