Abstract TP76: Step by Step: Implementing Post-Acute Stroke Standards

Abstract

Introduction: Certification programs and quality improvement initiatives improve outcomes among patient populations. Stroke rehab expertise, care processes, and educational resources vary among sites where post-acute care (PAC) is delivered. The Misson: Lifeline Stroke PAC Initiatives are recruiting sites in four states to implement the AHA PAC Stroke Program Standards. Purpose Developed from evidence-based rehab and proven secondary prevention interventions, the American Heart Association (AHA) created quality standards based on the AHA 2016 Guidelines for Adult Stroke Rehabilitation and Recovery to address gaps in PAC care. Methods: Nursing facilities (SNFs), critical access hospitals (CAHs) with swing beds, and inpatient rehab facilities (IRFs) in Iowa, Montana, Nebraska, and North Dakota were recruited to participate in the Initiative. Sites received education on the PAC Stroke Program standards and individualized quality improvement support. Sites were enrolled in the Healthcare Network, a collaborative tool to start discussions, share resources, and discuss patient care processes, and the Quality and Certification Tool, used to track clinical measures and outcome metrics. Monthly virtual learning collaboratives were held to share educational materials, community resources, and processes for patient care.Statewide AHA conferences and workshops facilitated in-person collaboration across settings. A pre-implementation survey was utilized to identify gaps in existing practices. A post-implementation survey will be used to assess the effectiveness of these initiatives. Results: Forty-seven facilities were recruited including 10 IRFs, 17 CAHs and 20 SNFs. Additional sites will be added throughout the project. 100% of facilities completed orientation. Nine learning collaboratives have been hosted and 26 facilities completed the pre-implementation survey. Data submissions and review are ongoing through 2025. Conclusions: Future evaluation of implementation of standards is needed to assess improvements in patient outcomes. The participation of 47 facilities shows a need for more organized initiatives that help health care professionals incorporate research proven standards for stroke rehab.