Optimizing Stroke Systems of Care by Enhancing Transitions Across Care Environments

Abstract

Abstract-Stroke affects many aspects of the lives of stroke survivors and their family caregivers. Supporting long-term recovery and rehabilitation are necessary to help stroke survivors adapt to living with the effects of stroke and to help family members adapt to the caregiving role. During recovery and rehabilitation, many elements of the health care continuum are utilized, including emergency response, acute care, inpatient and outpatient rehabilitation, and community and long-term care. With the advent of thrombolytic therapy and the benefits of stroke units, stroke survival and outcomes are improving. As a result, the current emphasis of stroke system improvement is to implement stroke units throughout the developed world. To enhance the patient centeredness of stroke care delivery, an important next phase of stroke system improvement will center on the experiences of stroke survivors and their family caregivers as they move through diverse care environments. The objective of this article was to conduct a scoping review of the literature on stroke transitions to identify the current areas of research emphasis. This article highlights stroke survivors' and family caregivers' experiences with transitions across care environment and some potential strategies to improve those transitions.

Young and Midlife Stroke Survivors’ Experiences With the Health Services and Long-Term Follow-Up Needs

“…Challenges related to family life and the return to work have also been identified as topics of importance to younger stroke survivors (Gilworth, Phil, Cert, Sansam, & Kent, 2009;Kitzmüller, Asplund, & Häggström, 2012;Martinsen et al, 2012;Medin et al, 2006). The shortcomings appear to be especially prominent during transitions between health service institutions (Cameron, Tsoi, & Marsella, 2008;Hickey, Horgan, O'Neill, & McGee, 2012;Leith, Phillips, & Sample, 2004;Salisbury, Wilkie, Bulley, & Shiels, 2010;White et al, 2009). To the best of our knowledge, young and midlife stroke survivors' specific long-term needs and how they are addressed by the health services have received little attention thus far.…”

Transition of care for the elderly after cerebrovascular accidents - from hospital to the home

“…The strategies may be divided into: aspects involving society, the system of care, and the person involved in this process (21) .…”

“…In the The educative approach remains incipient for the families and the patients who suffered strokes, as does the management of this care. There is, therefore, a need to implant educational models so that the patients and their families may provide the care, in the period of transition from hospital to the home (21) , in a real context for each family, with its culture, beliefs and relationships with the elderly person, in this prolonged period of care.…”

Supporting citizen-centered care for seniors - experiences from two Swedish research projects

“…The acute phase of stroke care has received a lot of focus, and it is recognized that stroke units, thrombolytic therapy, and enhanced rehabilitation may significantly improve patient care and outcomes. Aspects of stroke care associated with transitions across care environments have however yet received little attention [26].…”