Wednesday, December 19, 2012

Navigating the Poststroke Continuum of Care

There is no continuum of stroke care because there is such poor to non-existant knowledge of how to get to recovery. Only 10% fully recover.
You could have the best medical resources in the world get together and they still would do no better than 10% fully recovered. This is so obvious, prevent the neuronal cascade of death, saving trillions of neurons daily.
With less damage recovery might be possible.
http://www.strokejournal.org/article/PIIS1052305711001492/abstract?rss=yes
Stroke is a significant source of death and disability worldwide. The increasing prevalence of stroke survivors forecasts substantial socioeconomic burden and a greater need for comprehensive poststroke rehabilitative services. Despite the rapidly rising burden of cerebrovascular disease, particularly in developing countries, there has been limited implementation of multidisciplinary stroke units, a proven care modality in reducing patient mortality and improving functional outcomes. Transitioning from these acute inpatient settings to in- and outpatient rehabilitation or long-term care environments has consistently been identified as an obstacle to quality stroke rehabilitation. To address the barriers preventing the seamless delivery of poststroke care, an evaluation of patient–caregiver perspectives, treatment challenges, and system-wide shortcomings is presented. The fragmentation of the current poststroke chain of care could benefit from the introduction of case managers or “navigators,” discharge planning, electronic medical records, and evidence-based neurorehabilitation guidelines. By aiding in successful care transitions, these proposed efforts could advance post–acute stroke patients along the care continuum to achieve their rehabilitative goals.

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