Are you looking for an interesting Quality Improvement project for 2017? If so, what about this one? This is something that I have developed for an acute stroke unit in New South Wales Australia, and, considering it’s applicability, thought “why not share it” so others can do the same. Here’s hoping the document attached gives you a useful starting point, but of course, you’ll need to modify the project to your own clinical context.
If you’re happy to share your final de-identified results with me, please add this into your ethics application and email them to me at changingstroke@gmail.com at the completion of the project. Here’s wishing you all the best!
Aim
To translate stroke recovery evidence into practice: Increasing the time acute inpatients spend doing everyday activities to more than 50% of their waking hours.
Background
Evidence indicates that maximizing early recovery in patients with stroke requires a “Time is Function” [1] approach, which promotes patient involvement in a multi-modal program [2], includes repetitive, intensive, meaningful, task-specific training (rimTST) [3] and is provided in an enriched, enabling environment [4].
This approach aims to take full advantage of the brain’s ability to reorganize early after stroke [5-8]. Although recent evidence indicates that very early mobilization after stroke does not influence long-term mobility outcomes, Bernhardt et al nevertheless found “a 13% improvement in the odds of a favourable outcome with each additional session of out-of-bed activity per day”.
There is general consensus that rehabilitation should be integrated into medical care and after stroke, should start within 2-3 days post-event, for patients admitted with stroke [9, 10] (Figure 1) and that there is a need to change the “cultural environment, especially in healthcare settings, to allow and encourage patients to be independent and to practice even if it takes more time and involves some risk” [10]…..
