Services for reducing duration of hospital care for acute stroke patients

Fearon, Patricia; Langhorne, Peter

doi:10.1002/14651858.cd000443.pub3

Cited by 130 publications

(183 citation statements)

References 46 publications

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“…3 The objective of this review was to summarize the literature related to one of these ESD programs to assist decision makers looking to establish, or refine, a best-practice postacute ESD program for stroke rehabilitation. This was done by narrowing the focus of our search to team-coordinated and delivered ESD programs described in the peer-reviewed literature and expanding search criteria beyond randomized controlled trials.…”

Section: Discussionmentioning

confidence: 99%

“…3 In this review, three forms of ESD intervention were identified: ESD team coordination and delivery, ESD team coordination only, and no ESD team. Statistically significant differences between ESD and conventional care were only noted for the two primary outcomes of death or institutionalization, and death or dependency among studies where ESD was team-coordinated and delivered (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…The authors of this review noted that further research should be completed to "define the important characteristics of effective ESD services." 3 In a consensus report on the topic, an international panel of experts on ESD unanimously agreed that specific eligibility criteria for early supported discharge should be used and that eligibility decisions should be based in part on the patient's level of disability and medical stability. 4 The panel also unanimously agreed that identification of patients suitable for ESD should be made by the ESD team and that flexibility in the criteria is essential.…”

Section: Introductionmentioning

confidence: 99%

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A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

Meyer

Teasell

Thind

et al. 2016

Can. J. Neurol. Sci.

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This review aimed to summarize data from peer-reviewed studies of team-coordinated and delivered early supported discharge (ESD) for postacute, poststroke rehabilitation. A systematic review was performed in Medline, Embase, and CINAHL for appropriate studies. Information on program details and patient cohorts was synthesized. All programs sought patients with mild-to-moderate functional impairment and minimal cognitive impairment (often based on Barthel Index and Mini-Mental State Examination scores, respectively). All also included at least one subjective admission criterion related to rehabilitation suitability or the suitability of the home environment. Based on the identified studies, ESD programs can assume that 15% of patients screened for ESD will be eligible and care should be provided for 4 to 5 weeks postdischarge. Although the benefits of team-coordinated and delivered ESD poststroke have been well-documented, this review may be helpful for clinicians, administrators, and policy makers looking to establish or refine an ESD program for stroke.RÉSUMÉ: Synthèse de la littérature revue par des pairs sur le congé hospitalier précoce avec soutien coordonné et fourni par une équipe de personnel soignant après un accident vasculaire cérébral. L'objectif de cette revue était de résumer les données des études revues par des pairs sur le congé hospitalier précoce avec soutien (CHPS) coordonné et fourni par une équipe de personnel soignant pour la réadaptation post aiguë après un accident vasculaire cérébral (AVC). Nous avons effectué une revue systématique dans les bases de données Medline, Embase et CINAHL pour identifier les études pertinentes. Nous avons effectué une synthèse de l'information sur les détails des programmes et sur les cohortes de patients. Tous les programmes visaient des patients ayant un déficit fonctionnel de léger à modéré et un déficit cognitif minime (souvent basé sur le score à l'indice de Barthel et au Mini-Mental State Examination respectivement). Tous incluaient également au moins un critère d'admission subjectif en lien avec l'adéquation du sujet et de son environnement domiciliaire à la réadaptation. D'après les études identifiées, les programmes de CHPS peuvent présumer que 15% des patients dépistés pour un CHPS y seront éligibles et que les soins devraient être prodigués pendant 4 à 5 semaines après le congé. Bien que les bénéfices du soutien coordonné et fourni par une équipe de personnel soignant après un CHPS aient été bien documentés, cette revue peut aider les cliniciens, les administrateurs et les décideurs qui prévoient établir ou perfectionner un tel programme pour l'AVC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

Meyer

Teasell

Thind

et al. 2016

Can. J. Neurol. Sci.

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“…These services have demonstrated their efficacy in reducing length of stay, reducing the likelihood of being admitted to institutional care, and in improving long term functional outcome (Fearon & Langhorne, 2012) Although recommended in the majority of international clinical guidelines, the evidence to date primarily supports domiciliary-based rehabilitation in urban areas. The only RCT carried out among a rural population did not find a significant benefit for ESD when compared with in-patient rehabilitation.…”

mentioning

confidence: 99%

Early Supported Discharge after stroke: a feasible and effective service model for a rural population

et al. 2017

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“…Although most of these missions seem admitted by all, there is no consensus today at the national level on their mode of operation and in particular on their vocation to provide the care or not. Internationally, there is the action of these teams of early supported discharge (ESD) with a focus mainly on the stroke literature [3][4][5][6] with a recent review of the literature Cochrane has shown the value of ESD (which include three types of care activities in France : inpatient, home hospitalization and mobile teams) including the length of hospital stay, independence and home support to 6 months, satisfaction and access to extended activities of daily living 3 .…”

Section: Introductionmentioning

confidence: 99%

Mobile team reintegration-rehabilitation: An activity outside. Results of 3 years of functioning to the Pole Saint-Helier

Durufle¹

2017

J Neurol Neuromedicine

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Many mobile teams were created over the past decade in various medical specialties including physical medicine and rehabilitation.The Pole Saint Helier has created a mobile team of reintegration -rehabilitation (EM2R) in December 2012 with support from the Regional Health Agency of Brittany. It operates on the health territory No. 5 of Brittany near people experiencing neurological disability. Its main mission is to implement the necessary devices to facilitate the home return of people hospitalized after a neurological event or maintaining to home people with neurological disorders.

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Services for reducing duration of hospital care for acute stroke patients

Cited by 130 publications

References 46 publications

A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

A Synthesis of Peer-Reviewed Literature on Team-Coordinated and Delivered Early Supported Discharge After Stroke

Early Supported Discharge after stroke: a feasible and effective service model for a rural population

Mobile team reintegration-rehabilitation: An activity outside. Results of 3 years of functioning to the Pole Saint-Helier

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