When the hell will we get EXACT PROTOCOLS that follow from an EXACT DAMAGE DIAGNOSIS? Guidelines do nothing that will guarantee recovery. This is very bad; 'care' NOT RECOVERY OR RESULTS!
What a useless guideline. I'd have you all fired for NOT CREATING EXACT PROTOCOLS!
DOD and VA Release New Stroke Rehabilitation Guidelines to Improve Patient Outcomes
In August 2024, the Department of Veterans Affairs and
the Department of Defense released new clinical practice guidelines for
the management of stroke rehabilitation for their health care providers.
The VA/DOD Clinical Practice Guideline for Management of Stroke
Rehabilitation for 2024 updates guidelines published in 2019. The new
guidelines provide comprehensive, evidence-based recommendations for the
management of stroke rehabilitation.
Dr. Jenifer Meno, deputy chief, Defense Health Agency Clinical Quality
Improvement Program/Medical Affairs/Clinical Support Division, explained
that new guidelines were established because of new research and care(NOT RECOVERY!)
for stroke rehabilitation in the past five years.
“In support of the interagency partnership of continual learning,
recommendations from the VA/DOD clinical teams, congressional interest,
and changes in medical treatment, the evidence-based work group updates
or develops new CPGs,” said Meno.
The new guidelines aim to improve clinical outcomes by providing an
evidence-based framework for evaluating and managing care(NOT RECOVERY!) for adult
patients, 18-years or older, who have experienced a stroke.
“Clinical practice guidelines serve as the foundations for delivering
safe, standardized, and quality clinical care(NOT RECOVERY!),” said U.S. Public Health
Service Capt. Margaret Rincon, chief, DHA Clinical Quality Improvement
Program/Medical Affairs/Clinical Support Division. “These guidelines
provide clinical care(NOT RECOVERY!) recommendations based on an expansive review of
evidence-based research … bringing the knowledge and insights of the
most recent clinical research to the fingertips of clinical teams.”
Rincon explained that CPGs provide a standardized approach to the
delivery of care(NOT RECOVERY!) that is backed by research demonstrating improved or
best clinical outcomes.
Meno said, “The clinical practice guideline includes evidence-based
practice to support better outcomes provided to all beneficiaries. As an
example, for stroke rehabilitation, there are tools to help patients
and families with questions after a stroke ranging from communication
with family and friends to resuming activities … each CPG provides tools
that support the clinician and patients’ opportunity for shared
decision making and address specific patient needs.”
Significant Updates to CPGs
The management of stroke rehabilitation work group, which prepared the
document, stressed the importance that providers review this new version
of the CPGs.
An updated algorithm and sidebars defining a clinical flow, and 24 new
recommendations were some of the major changes made. Meno explained
there were 19 previous recommendations that were replaced, three
amended, and 16 recommendations that were deleted from the 2019 version.
The new algorithm format represents a simplified flow for the management
of stroke rehabilitation patients and fosters efficient shared decision
making by providers and patients, explained Rincon. It includes steps
of care(NOT RECOVERY!) in an ordered sequence, decisions to be considered, decision
criteria recommended, and actions to be taken. The algorithm is a
step-by-step decision tree.
A major strength seen in this new guideline is the coordination and
collaboration of multidisciplinary teams ensuring a broad representation
of providers engaged in the management of stroke rehabilitation.
Patient-Centered Care(NOT RECOVERY!)
By representing a holistic approach to health care, the guidelines
encourage providers to adopt a patient-centered, culturally appropriate
delivery system that is also available to people with limited literacy
skills and physical, sensory, or learning disabilities. According to the
guidelines, regardless of the care setting, all patients should have
access to individualized evidence-based care(NOT RECOVERY!).
These CPGs also encourage providers to practice shared decision making, a
process in which providers, patients, and patient care partners (such
as family, friends, caregivers) consider clinical evidence of benefits
and risks as well as patient values and preferences to make decisions
regarding the patient’s treatment. Providers are encouraged to use
shared decision making to individualize treatment goals and plans based
on patient capabilities, needs, and preferences.
“CPGs support the priorities of building a modernized, integrated, and
resilient health care(NOT RECOVERY!) delivery system, said Meno. “The CPGs also support
the provision of providing excellence in patient-centered and
evidence-based care(NOT RECOVERY!).”
A Successful Implementation
The VA/DOD collaboration recommends several focal points for the successful implementation of this CPGs, including:
• Assess the patient’s condition and collaborate with the patient,
family, and caregivers to determine optimal management of care
• Emphasize the use of patient-centered care and shared decision making
• Minimize preventable complications and morbidity
• Optimize individual health outcomes and quality of life
DHA’s Virtual Education Center Support CPGs
The DHA’s Virtual Education Center contains more than 50,000 education
resources covering 60 medical topics, giving patients using a mobile
device or computer with internet access to validated health and medical
information.
According to Meno, the Virtual Education Center can significantly support CPGs in several ways, including:
• Access to up-to-date, validated information
• Provider support
• Provide patients credible health information
• Patient support
• Curated digital content packages aligned to the CPGs
“Overall, the VEC enhances the effectiveness of CPGs by providing
accessible, validated, and up-to-date information to both health care
providers and patients, improving compliance and health outcomes,” said
Meno.
In collaboration with the VA, the DHA Clinical Practice Guidelines team
updates, develops, and monitors 25 guidelines utilizing evidence-based
practices. This partnership, along with understanding the needs of
patients from both the military and veteran health care systems, leads
to improved patient outcomes.
Rincon emphasized the “guidelines are designed to provide information
and assist decision making and are not intended to define a standard of
care and should not be construed as one. Neither should they be
interpreted as prescribing an exclusive course of management.”
The guideline was prepared by the Management of Stroke Rehabilitation
Work Group, with support of the VA Office of Quality and Patient Safety,
and the DHA Clinical Quality Improvement Program.
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