When it comes to stroke we know that every minute matters in recognizing symptoms, calling 911 and accessing emergency stroke care. But did you know that minutes also matter to patients participating in stroke rehabilitation?
“Stroke Rehabilitation is a goal-oriented set of therapies and activities as part of patient care post-stroke.” Canadian Stroke Best Practice Guidelines. Research about best practice and patient views tell us that more therapy is better for improving function. Approximately 18 months ago, a team of frontline clinicians, their Program Manager, and a performance indicator specialist came together to understand the intensity of therapy that patients were receiving at Providence Care. This would enable the team to work together to identify ways to better meet their patients’ needs.
The current team of Mary Jo Demers (PT), Heather Fairbairn (OT), Jessica Bouchard (SLP), Jana Roth (Decision Support) and Kathi Colwell (Program Manager) meet regularly to improve stroke team knowledge, data quality, and reporting about the rehabilitation time that patients receive. They have shared their work with other committees at Providence Care Hospital, within the Southeast Stroke Network and most recently, in March 2017, with the Central East Stroke Network. The team presented at the Rehabilitation Intensity Forum for other teams to learn from their work.
“Working with the Rehab Intensity group has been a great collaboration. It has been very rewarding to be part of such a dynamic and motivated group and to provide the data they need to understand what they are achieving and how they can improve”, said Jana Roth. When it comes to the success of the Rehab Intensity Group, the common theme seems to be collaboration.
Mary Jo Demers, Physiotherapy Professional Practice Leader at Providence Care Hospital, said: “I see Rehab Intensity as an Interprofessional approach to our patient care; this includes daily organization of the treatment to ensure that each patient is getting the maximum amount of therapy we can provide, and the means in which we analyze our data and collaborate to guide the necessary changes.”
Earlier in June the Ontario Stroke Network (OSN) report card was released and for the first time there was a performance indicator reporting on Rehabilitation Intensity (minutes per day of therapy delivered by core therapies of Physiotherapy, Occupational Therapy and Speech Language Pathology). While the recommended target to strive for according to experts and best practice is 180 minutes per day, the median across the province is 62.6 minutes for stroke patients receiving inpatient rehabilitation. Providence Care Hospital is significantly above this average at 86.4 minutes last year, and we continue to work diligently to deliver even more therapy time. This means that many patients at Providence Care Hospital receive more minutes per day based on their goals and ability to tolerate intensive therapy. In addition, patients receive support from nursing staff, allied health professionals, other care team members and family to support additional practice time for therapy to support their recovery.
June is Stroke Month and with this in mind, we wanted to take the time to feature this dedicated group of staff who have been tirelessly working towards this recommendation for Rehab Intensity. For more information on stroke visit the Stroke Network of Southeastern Ontario.