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.

Monday, December 17, 2018

How is the audit of therapy intensity influencing rehabilitation in inpatient stroke units in the UK? An ethnographic study

Useless since these are guidelines with NO effective rehab protocols supporting them. Damn it all, start demanding results, NOT just guidelines, processes or targets. RESULTS! 

How is the audit of therapy intensity influencing rehabilitation in inpatient stroke units in the UK? An ethnographic study

  1. Elizabeth Taylor1,
  2. Fiona Jones1,
  3. Christopher McKevitt2

Author affiliations

  1. Faculty of Health, Social Care and Education, Department of Rehabilitation Sciences, Kingston University and St George’s University of London, London, UK
  2. School of Population Health and Environmental Sciences, King’s College London, London, UK
  1. Correspondence to Dr Elizabeth Taylor; elizabeth.taylor@sgul.kingston.ac.uk

Abstract

Objectives Occupational therapy, physiotherapy and speech and language therapy are central to rehabilitation after a stroke. The UK has introduced an audited performance target: that 45 min of each therapy(So the doctor involved does absolutely nothing and is totally useless?) should be provided to patients deemed appropriate. We sought to understand how this has influenced delivery of stroke unit therapy.
Design Ethnographic study, including observation and interviews. The theoretical framework drew on the work of Lipsky and Power, framing therapists as ‘street level bureaucrats’ in an ‘audit society’.
Setting Stroke units in three English hospitals.
Participants Forty-three participants were interviewed, including patients, therapists and other staff.
Results There was wide variation in how therapy time was recorded and in decision-making regarding which patients were ‘appropriate for therapy’(I expect 100% recovery for all, don't cherry pick the less disabled patients. How would you feel if I told you were not good enough to get rehab? Or do you conveniently lie by omission?) or auditable. Therapists interpreted their roles differently in each stroke unit. Therapists doubted the validity of the audit results and did not believe their results reflected the quality of services they provided. Some assumed their audit results would inform commissioning decisions. Senior therapy leaders shaped priorities and practices in each therapy team. Patients were inactive outside therapy sessions. Patients differed regarding the quantity of therapy they felt they needed but consistently wanted to be more involved in decisions and treated as individuals.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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