Stroke Inpatient Rehabilitation Team Conferences: Leadership and Structure Improve Patient Outcomes

The ones I had were completely and totally fucking useless. There was never any discussion of you do this therapy 5000? times and you will get this result. Survivors don't want improvement, they want 100% recovery. Stop with your tyranny of low expectations.  You are doing a complete disservice to your medical profession.

Stroke Inpatient Rehabilitation Team Conferences: Leadership and Structure Improve Patient Outcomes

Author links open overlay panelDavid S.KushnerMD, FAAN*

Dale C.StrasserMD^†

https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104622Get rights and content

Abstract

Consensus on how rehabilitation teamwork and services are optimally coordinated continues to be a work in progress. One area of recent research has been inpatient-rehabilitation team conferences in stroke. The prevalence of Americans living with stroke is expected to gradually increase as the U.S. population ages, as will the related direct and indirect costs. Effective interdisciplinary team conferences during acute-stroke inpatient-rehabilitation are key to managing long-term costs while improving functional outcomes. Effective team conferences help to identify patients at risk for medical complications and institutionalization and help to determine interventions that will focus on patients’ medical, physical, cognitive, emotional, and social barriers to recovery and barriers to a community/home disposition. This scoping review paper identifies and analyzes literature on theory and structure of effective teams with the focus on stroke interdisciplinary rehabilitation team conferences and offers suggestions for improvement. Potential flaws of commonly used team conference formats are described. Studies are outlined showing associations between stroke patient outcomes and better care coordination and leadership in medical teamwork; and 2 examples of successful interdisciplinary team conference models used in stroke inpatient-rehabilitation are provided that support a case for a proactive, conscious structure to team conferences. Given the complexity of many stroke patients’ clinical care, greater attention to team functioning, and especially team conference leadership and structure, may be a promising area of focus to improve the quality of health care services for people with stroke.

 

 

Family Conferences in Stroke Rehabilitation: A Literature Review

I got absolutely nothing out of the family conferences I had, but maybe that was the fault of my doctor since there was no diagnosis, no stroke protocol, and nothing about what recovery would look like.
http://www.strokejournal.org/article/S1052-3057%2812%2900408-9/abstract

Background

Family conferences in hospital settings are acknowledged as being important and beneficial for enhancing communication between patients, family members, and the multidisciplinary team. They provide feedback on progress and therapeutic findings, and facilitate problem solving in cases of complex discharge planning.

Methods

A literature review was conducted, with 23 articles highlighting problem areas within current practice and discussing the merits of existing approaches.

Results

The articles suggest that stroke survivors and their families have additional education and support needs beyond what is already provided, and that intervention may be enhanced by being more proactive rather than reactive, preventing potentially avoidable crises or disputes. This review provides insight into the ideal methods for communicating and planning and identifies better uses of these opportunities.

Conclusions

Much more can be done within the multidisciplinary team to ensure that the information needs of patients and families are catered for during their inpatient admission and on their return to the community. Additional research and trials of interventions by established rehabilitation services will allow for improved and more informed clinical practice (including cost effectiveness), enhanced knowledge of caregiver needs, and essentially more positive outcomes for rehabilitation patients and their families. Research may be able to develop best practice guidelines to ensure reduced caregiver stress and anxiety during admission and discharge. We require additional investigation of the effects of educational and emotional support provided in the hospital setting and as an outpatient on quality of life for caregivers and prevention of readmission to hospital or entrance into residential care for patients.

My god, this is so easy to solve. You just ask experienced survivors what they should have been told. I wrote a complete blog post on that subject;
What my doctor should have told me.