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, March 18, 2024

St. John's Rehab(Toronto, Ontario) Recognized as a Leading Practice for Optimizing Virtual Care in Outpatient Rehab

You do realize survivors want recovery NOT 'CARE'?  Or does this hospital not know that survivors want 100% recovery? Are they that fucking stupid? And their board of directors is OK with such incompetence? 12 references to 'care'; NOT a single reference to recovery!

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling supposedly smart stroke medical persons they know nothing about stroke survivors is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

St. John's Rehab(Toronto, Ontario) Recognized as a Leading Practice for Optimizing Virtual Care in Outpatient Rehab

March 18, 2024

In the face of the global pandemic, the Outpatient (OP) department at St. John’s Rehab took bold steps to ensure continuity in patient care by implementing virtual care for stroke patients. As the world slowly returned to in-person appointments, the department didn't just abandon virtual care; instead, they embarked on a ground-breaking journey to make virtual care a permanent fixture in their toolkit, leading to their recent recognition as a Leading Practice for Optimizing Virtual Care in Outpatient Rehab by Health Standards Organization.

The initiative was founded on the principles of patient-centeredness, appropriateness, goal-based care, efficacy, efficiency, and best practices for virtual care. Drawing from resources like the Canadian Stroke Best Practices Recommendations for Virtual Care (2020) and the Toronto Rehab Telerehab Toolkit V1 (2020), the OP team created an infrastructure that not only bridged the immediate challenges posed by the pandemic but also enhanced the way outpatient rehabilitation is delivered.

A steering committee was formed, comprising the OP patient care manager, project manager, OT/PT/SLP professional practice leaders, a patient partner, and a Toronto Stroke Network (TSN) representative. This committee conducted an extensive review of best practices, available resources, and an environmental scan, with feedback sought from current patients and clinicians through online surveys and follow-up meetings. The neuro team mapped the current and future states of the program, identifying 14 improvement opportunities that were prioritized using an effort-impact matrix.

These improvement opportunities were then distributed among four interprofessional working groups, ensuring a holistic approach with patient representation. Patient engagement was a key focus, aligning with Health Quality Ontario’s Patient Engagement Framework.

Post-implementation, the impact on clinicians was significant. Surveys and structured research interviews revealed increased knowledge and satisfaction with VC tools, leading to a greater willingness to provide VC. Clinicians noted the potential of VC in addressing transportation challenges, involving family/caregivers in therapy sessions, and extending geographical reach to patients residing farther from the hospital.

Patients echoed these sentiments, highlighting the flexibility in scheduling, improved patient-oriented care, and the unique advantage of assessments within their home environment. VC became a catalyst for earlier access, enhanced patient-centeredness, interprofessional collaboration, and effective discharge planning.

The success of this initiative aligns seamlessly with St. John’s Rehab’s Strategic plan under the "Innovating Our Work" section. With virtual care infrastructure in place, St. John’s Rehab’s OP team has set a new standard for outpatient rehabilitation, ensuring that the benefits of virtual care are maximized to deliver efficient, patient-centered, and holistic rehabilitation services.


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