229 NEW STROKE EARLY SUPPORTED DISCHARGE SERVICE PROVIDES ALTERNATIVE REHAB PATHWAY AND IMPROVES PATIENT AND ORGANISATIONAL OUTCOMES

Abstract

Abstract Background Early Supported Discharge (ESD) for stroke is an international model of best care for stroke patients. ESD improves patient outcomes while facilitating a faster hospital discharge through providing stroke specific rehabilitation at home. ESD can be expected to improve disability outcomes and quality of life and reduce length of hospital stay. A pilot ESD service was introduced to this model 3 hospital in 2021 which encompasses a large geographical rural area that historically had an absence of Stroke rehabilitation services. Methods A retrospective review of routine data extracted from 57 patients accepted to the ESD service in 2021 was completed. This initial examination explored the effectiveness of ESD with the population in this rural area. Service Objectives as follows: (1) Improve patient’s functioning as measured by Functional Independence Measure (FIM) and Functional Assessment Measures (FAM); (2) Demonstrate a reduction in disability outcomes as evidenced on the Modified Rankin Scale (MRS); (3) Increase number of early supported discharges directly home for patients; and (4) Reduce length of hospital stay for patients post-stroke. Results Implementation of an ESD service over a 12-month period achieved the following: (1) 8.1% improvement in total FIM/FAM scores indicating positive functional outcomes and enhanced independence when discharged home with ESD; (2) A decrease in the average MRS score indicating improved disability outcomes; (3) 25% of all stroke patients in 2021 were discharged with ESD rehabilitation; (4) An increase of 12% in total number of discharges home post stroke from 2020 to 2021; (5) 244 bed saving days. Conclusion The introduction of an ESD service resulted in patient and organisational benefits. Participation in ESD rehabilitation had a positive impact on reduction of disability scores captured using MRS and improvements in functional outcome measure scores captured using the FIM/FAM.