BACKGROUND AND PURPOSE: Research evidence supporting Early Supported Discharge (ESD) services has been summarized in a Cochrane Systematic Review. Trials have shown that ESD can reduce long-term dependency and admission to institutional care and reduce the length of hospital stay. No adverse impact on the mood or well-being of patients or carers has been reported. With the implementation of many national and international stroke initiatives, we felt it timely to reach consensus about ESD among trialists who contributed to the review. METHODS: We used a modified Delphi approach with 10 ESD trialists. An agreed list of statements about ESD was generated from the Cochrane review and three rounds of consultation completed. ESD trialists rated statements regarding team composition, model of team work, intervention, and success. RESULTS: Consensus of opinion (>75% agreement) was obtained on 47 of the 56 statements. Multidisciplinary, specialist stroke ESD teams should plan and co-ordinate both discharge from hospital and provide rehabilitation in the community. Specific eligibility criteria (safety, practicality, medical stability, and disability) need to be followed to ensure this service is provided for mild to moderate stroke patients who can benefit from ESD. Length of stay in hospital, patient and carer outcome measures and cost, need to be routinely audited. CONCLUSIONS: We have created a consensus document that can be used by commissioners and service providers in implementing ESD services. Our aim is to promote the use of recommendations derived from research findings to facilitate successful implementation of stroke services nationally and internationally.
BACKGROUND AND PURPOSE: Research evidence supporting Early Supported Discharge (ESD) services has been summarized in a Cochrane Systematic Review. Trials have shown that ESD can reduce long-term dependency and admission to institutional care and reduce the length of hospital stay. No adverse impact on the mood or well-being of patients or carers has been reported. With the implementation of many national and international stroke initiatives, we felt it timely to reach consensus about ESD among trialists who contributed to the review. METHODS: We used a modified Delphi approach with 10 ESD trialists. An agreed list of statements about ESD was generated from the Cochrane review and three rounds of consultation completed. ESD trialists rated statements regarding team composition, model of team work, intervention, and success. RESULTS: Consensus of opinion (>75% agreement) was obtained on 47 of the 56 statements. Multidisciplinary, specialist stroke ESD teams should plan and co-ordinate both discharge from hospital and provide rehabilitation in the community. Specific eligibility criteria (safety, practicality, medical stability, and disability) need to be followed to ensure this service is provided for mild to moderate strokepatients who can benefit from ESD. Length of stay in hospital, patient and carer outcome measures and cost, need to be routinely audited. CONCLUSIONS: We have created a consensus document that can be used by commissioners and service providers in implementing ESD services. Our aim is to promote the use of recommendations derived from research findings to facilitate successful implementation of stroke services nationally and internationally.
Authors: Janet Prvu Bettger; Sara B Jones; Anna M Kucharska-Newton; Janet K Freburger; Sylvia W Coleman; Laurie H Mettam; Mysha E Sissine; Sabina B Gesell; Cheryl D Bushnell; Pamela W Duncan; Wayne D Rosamond Journal: Neurology Date: 2019-01-11 Impact factor: 9.910
Authors: Lisa Shaw; Nawaraj Bhattarai; Robin Cant; Avril Drummond; Gary A Ford; Anne Forster; Richard Francis; Katie Hills; Denise Howel; Anne Marie Laverty; Christopher McKevitt; Peter McMeekin; Christopher Price; Elaine Stamp; Eleanor Stevens; Luke Vale; Helen Rodgers Journal: Health Technol Assess Date: 2020-05 Impact factor: 4.014
Authors: Mary E Walsh; Jan Sorensen; Rose Galvin; David Jp Williams; Joseph A Harbison; Sean Murphy; Ronan Collins; Dominick Jh McCabe; Morgan Crowe; N Frances Horgan Journal: Eur Stroke J Date: 2018-03-15
Authors: Benjamin Hotter; Inken Padberg; Andrea Liebenau; Petra Knispel; Sabine Heel; Diethard Steube; Jörg Wissel; Ian Wellwood; Andreas Meisel Journal: Eur Stroke J Date: 2018-04-19
Authors: Katharina S Sunnerhagen; Anna Danielsson; Lena Rafsten; Ann Björkdahl; Åsa B Axelsson; Åsa Nordin; Cathrine A Petersson; Åsa Lundgren-Nilsson; Karin Fröjd Journal: BMC Neurol Date: 2013-06-24 Impact factor: 2.474