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Evaluation of stroke early supported discharge services. Collaborative Leadership in Applied Health Research and Care (CLAHRC), Nottinghamshire, Derbyshire and Lincolnshire, UK

A Cochrane systematic review showed that Early Supported Discharge (ESD) following a stroke is both a safe and cost-effective alternative to continued in-patient management. Currently it is unclear whether the health and cost benefits established in the research literature still apply when ESD servi...

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Autores principales: Gaynor, C, Fisher, R, Kerr, M, Nouri, F, Cobley, C, Stariradeva, I, Moody, A, Sayers, H, Walker, M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Igitur Publishing 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184804/
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author Gaynor, C
Fisher, R
Kerr, M
Nouri, F
Cobley, C
Stariradeva, I
Moody, A
Sayers, H
Walker, M
author_facet Gaynor, C
Fisher, R
Kerr, M
Nouri, F
Cobley, C
Stariradeva, I
Moody, A
Sayers, H
Walker, M
author_sort Gaynor, C
collection PubMed
description A Cochrane systematic review showed that Early Supported Discharge (ESD) following a stroke is both a safe and cost-effective alternative to continued in-patient management. Currently it is unclear whether the health and cost benefits established in the research literature still apply when ESD services are implemented in practice. Our study aims to evaluate the implementation of stroke ESD across three counties in the UK (Nottinghamshire, Derbyshire, Lincolnshire), and offers an innovative approach to facilitate the translation of stroke rehabilitation research into clinical practice. Phase one of our study was to establish the key components of a successful ESD team based on the research literature. We used a modified Delphi approach with ten ESD trialists, who contributed to the Cochrane review, to produce a consensus document. This provides core guidelines for the implementation of an evidence-based ESD service. The second ongoing phase of our study involves the evaluation of ESD services in practice. The evaluation looks at changes in patients’ functionality over time, using a range of standardised questionnaires and robust statistical analysis. Such methods can be used by ESD teams in evaluating their effectiveness. Designing an evaluation of an established ESD team has raised some important methodological issues; these include the variability in the length of hospital stay prior to referral to ESD when compared to trials in the Cochrane review, and the subsequent difficulty in defining the optimal baseline time to consent patients. The findings from our research will help inform the implementation and delivery of evidence based ESD services in the UK and abroad.
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spelling pubmed-31848042011-10-03 Evaluation of stroke early supported discharge services. Collaborative Leadership in Applied Health Research and Care (CLAHRC), Nottinghamshire, Derbyshire and Lincolnshire, UK Gaynor, C Fisher, R Kerr, M Nouri, F Cobley, C Stariradeva, I Moody, A Sayers, H Walker, M Int J Integr Care Poster Abstract A Cochrane systematic review showed that Early Supported Discharge (ESD) following a stroke is both a safe and cost-effective alternative to continued in-patient management. Currently it is unclear whether the health and cost benefits established in the research literature still apply when ESD services are implemented in practice. Our study aims to evaluate the implementation of stroke ESD across three counties in the UK (Nottinghamshire, Derbyshire, Lincolnshire), and offers an innovative approach to facilitate the translation of stroke rehabilitation research into clinical practice. Phase one of our study was to establish the key components of a successful ESD team based on the research literature. We used a modified Delphi approach with ten ESD trialists, who contributed to the Cochrane review, to produce a consensus document. This provides core guidelines for the implementation of an evidence-based ESD service. The second ongoing phase of our study involves the evaluation of ESD services in practice. The evaluation looks at changes in patients’ functionality over time, using a range of standardised questionnaires and robust statistical analysis. Such methods can be used by ESD teams in evaluating their effectiveness. Designing an evaluation of an established ESD team has raised some important methodological issues; these include the variability in the length of hospital stay prior to referral to ESD when compared to trials in the Cochrane review, and the subsequent difficulty in defining the optimal baseline time to consent patients. The findings from our research will help inform the implementation and delivery of evidence based ESD services in the UK and abroad. Igitur Publishing 2011-08-01 /pmc/articles/PMC3184804/ Text en Copyright 2011, International Journal of Integrated Care (IJIC) http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Poster Abstract
Gaynor, C
Fisher, R
Kerr, M
Nouri, F
Cobley, C
Stariradeva, I
Moody, A
Sayers, H
Walker, M
Evaluation of stroke early supported discharge services. Collaborative Leadership in Applied Health Research and Care (CLAHRC), Nottinghamshire, Derbyshire and Lincolnshire, UK
title Evaluation of stroke early supported discharge services. Collaborative Leadership in Applied Health Research and Care (CLAHRC), Nottinghamshire, Derbyshire and Lincolnshire, UK
title_full Evaluation of stroke early supported discharge services. Collaborative Leadership in Applied Health Research and Care (CLAHRC), Nottinghamshire, Derbyshire and Lincolnshire, UK
title_fullStr Evaluation of stroke early supported discharge services. Collaborative Leadership in Applied Health Research and Care (CLAHRC), Nottinghamshire, Derbyshire and Lincolnshire, UK
title_full_unstemmed Evaluation of stroke early supported discharge services. Collaborative Leadership in Applied Health Research and Care (CLAHRC), Nottinghamshire, Derbyshire and Lincolnshire, UK
title_short Evaluation of stroke early supported discharge services. Collaborative Leadership in Applied Health Research and Care (CLAHRC), Nottinghamshire, Derbyshire and Lincolnshire, UK
title_sort evaluation of stroke early supported discharge services. collaborative leadership in applied health research and care (clahrc), nottinghamshire, derbyshire and lincolnshire, uk
topic Poster Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184804/
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