31 Stroke early supported discharge: continuing to improve patient and organisational outcomes

Abstract

Abstract Background Approximately 6,000 people in Ireland had a stroke in 2020. Early Supported Discharge (ESD) is an international model of care for stroke patients. ESD improves patient outcomes while facilitating a faster discharge, through provision of stroke specific rehab at home. ESD can be expected to improve disability outcomes, quality of life and reduce length of hospital stay. A pilot ESD service was introduced in an acute hospital in 2021 and continues to provide stroke rehab for patients living within a 30-minute drive from an acute hospital. Methods A retrospective re-audit on routine data from 113 patients who partook in ESD from January 2021 to December 2022 from an acute hospital. Data was extracted from the ESD database and analysed. Results Implementation of an ESD service over 24 months between 2021 and 2022 achieved the following: (i) 50% increase in number of bed saving days between 2021 and 2022; (ii) In both 2021 and 2022, the percentage of stroke patients discharged with ESD was 25% of the total number of stroke patients; (iii) The average LOS of a stroke patient accepted to the ESD service continues to decrease. In 2021, average LOS for ESD patients was 11.7 days; 2022 it was 11 days; (iv) The number of stroke patients accepted by ESD service remains relatively unchanged. In 2021, 57 patients and in 2022, 56 patients were accepted to ESD and (v) Total FIM/FAM scores from admission to discharge with ESD continue to increase. In 2021, 8.1% increase in functional outcomes were recorded. In 2022, that increased to 9.5% demonstrating an improving independence levels when discharged with ESD. Conclusion The ESD service in an acute hospital continues to demonstrate Organisational and patient benefits. Participation in ESD rehabilitation impacted positively on functional performance as captured using the FIM-FAM. Ongoing implementation of ESD aims to continue to have a positive impact on length of patient stay, bed saving days and functional outcomes.