TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Recommendations Guide (updated January 23, 2014)

Size: px
Start display at page:

Download "TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Recommendations Guide (updated January 23, 2014)"

Transcription

1 TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) Objective: To enhance system-wide performance and outcomes for persons with stroke in Toronto. Goals: Timely access to geographically located acute stroke unit care with a dedicated interprofessional team Earlier access to high intensity rehab Increase access to high intensity rehab for severe strokes Enhance outpatient rehab programs with timely access from acute care post mild stroke Improved functional outcomes Desired State: The literature stipulates that organized acute stroke care 1 and early access to intense rehabilitation improves patient outcomes. The desired state is described as: All acute stroke patients admitted to a stroke unit 40% of total stroke patients discharged from acute care to inpatient rehab with the admission to rehab day 5 for ischemic stroke and day 7 for hemorrhagic strokes System wide admissions to inpatient rehab by stroke severity (9% mild, 49.5% moderate, 41.5% severe at admission) and length of stay targets based on rehab patient group (RPG) 3 hours minimum therapy time/patient/day in rehab with direct to indirect staff to therapy ratio 80:20 Minimum 10 rehab beds per organization 7 day/week admissions and therapy/activity Patient transfers (inter and intra organizational) are minimised, if at all, once admitted Target admission to outpatient from acute within 2 weeks post stroke Referral as necessary to CCAC for early supported discharge from acute care Purpose of this document: The Toronto Stroke Networks have developed this document to assist organizations with prioritization and implementation of best practice to create a common standard of care across the system. This includes a summary of the key best practices, administrative and clinical processes required to meet these recommendations, and core and suggested process indicators. As the Quality-Based Procedures: Handbook for Stroke (HQO & MOHLTC, released January 2013) provides required best practice care procedures for all admitted acute stroke patients as part of the new funding model under the Health Services Funding Reform initiative, this best practice guide has been updated to reflect these procedures. To support successful uptake of best practice, a knowledge translation (KT) strategy has been developed to achieve: Professional development to enhance practice utilizing a combination of evidence-based KT education strategies Inter-professional collaborative team development for better patient outcomes Evaluation framework for monitoring and reporting Evaluation framework for monitoring and reporting Updated January 23, 2014 Page 1 of 8

2 STROKE UNIT REHAB Post acute stroke care should be delivered in a setting in which rehabilitation care is formally coordinated and organized. 4 All persons with stroke should be referred to a specialized rehabilitation team on a geographically defined unit. 5 Persons with moderate or severe stroke who have rehabilitation potential and rehabilitation goals should be given an opportunity to participate in inpatient stroke rehabilitation. 6 TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) A specialized, geographically defined rehabilitation unit dedicated to the rehabilitation of persons with stroke. 7 Persons with stroke should move to the stroke rehabilitation unit as soon as possible, ideally within 5 days of stroke onset (note: hemorrhagic strokes may require more time in acute care before transfer to rehab). 8 Procedures should enable admission 7 days/week (OSN Stroke Reference Group) System-wide percent of rehab admissions by rehabilitation patient group (RPG):9% mild, 49.5% moderate, 41.5% severe; with target LOS by RPG Stroke Severity RPG Severe Moderate Mild Target LOS /Activities The goal of the stroke rehabilitation unit is to maximize potential recovery so that persons with stroke may be able to function at the highest physical and mental ability they can achieve post stoke. 9 Based on current literature, it is recommended that stroke rehabilitation units have a minimum of 10 beds to support a dedicated complement of nursing and allied healthcare professions (such as OT, PT, S- LP, and SW). 10 (year 1) Comprehensive, evidence-based written protocols, order sets and care pathways/algorithms should be in place to guide stroke rehabilitation. 11 (year 1) Protocols and strategies to prevent complications (e.g. falls, DVT, pneumonia, etc.) and the recurrence of stroke developed and communicated to all staff. 12 (year 2) to manage re-admissions to acute care. (year 2) Proportion of persons with mild, moderate and severe stroke (by RPG) admitted directly from an acute care unit to a high intensity stroke rehabilitation unit (core). Number of persons with stroke treated in a geographically defined stroke rehabilitation unit at any time during their inpatient rehabilitation phase following an acute stroke event (core). Final discharge disposition for persons with stroke following inpatient rehabilitation: o Percentage discharged home o Percentage discharged to a long-term care facility o Percentage requiring readmission to an acute care hospital for stroke-related causes (core). Median length of time between stroke onset and admission to stroke inpatient rehabilitation. Average LOS in inpatient rehabilitation, by stroke severity (RPGs). STAFFING MIX The interprofessional rehabilitation team should consist of a physician, nurse, physical therapist, occupational therapist, speech-language pathologist, social worker, Services are provided by a dedicated interprofessional team with expertise in stroke rehabilitation. 14 Stroke rehabilitation units adequately staffed with healthcare providers with expertise in Stroke unit teams should conduct at least one System and process changes to allow therapists Healthcare providers (by formal interprofessional meeting per week 17 to to spend approximately 80 percent of their time profession OT, PT, S-LP, and SW) identify rehabilitation challenges, to set rehab with persons with stroke 18 to support the to person with stroke ratio. goals, to monitor progress, discuss discharge appropriate intensity of rehab (see section on plans and to support persons with stroke Assessment and Management). (year 2) during and after their inpatient stay. Minimum allied health staffing (6bed unit) Updated January 23, 2014 Page 2 of 8

3 psychologist, recreation therapist, and persons with stroke, their families and/or caregivers. 13 TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) stroke rehabilitation. 15 Post acute stroke care should be delivered by a variety of treatment disciplines, experienced in providing post-stroke care, to ensure consistency and to reduce the risk of complications. 16 /Activities 1FTE OT 1 FTE PT S-LP 1:12 (year 1) (OSN Stroke Reference Group) ASSESSMENT AND MANAGEMENT The interprofessional rehabilitation team should assess persons with stroke within 24 to 48 hours of admission and develop a comprehensive individualized rehabilitation plan, which reflects stroke severity and the needs and goals of persons with stroke. 19 Ensure staff have access to training of standardized, valid assessment or screening tools. Shared decision-making and goal setting should involve the interprofessional team, persons with stroke and their families/caregivers. The care management plan should include: o A pre-discharge needs assessment to ensure a smooth transition to the community. o A home visit by a healthcare professional (ideally before discharge) to assess home environment and suitability for safe discharge. o Assessment of equipment needs and home modifications. o Caregiver training on how a person with stroke will manage activities of daily living and instrumental activities of daily living in his/her environment. 20 Healthcare providers to maintain credentialing and competency on standardized assessment tools. These include: MOCA, FIM Instrument, Berg Balance Scale and Chedoke McMaster Stroke Assessment. (year 2) Protocols and processes in place to guide stroke rehabilitation care., protocols, and resources for assessing equipment needs and conducting home assessments by interprofessional team members soon after the stroke. Proportion of persons with stroke who have rehab goals established within 48 hours. Healthcare providers should use standardized, valid assessment tools when evaluating stroke-related impairments and functional status (Appendix B). The FIM Instrument should be used as a standardized assessment tool (OSN Stroke Reference Group) Patients who fail a swallowing screen or present with features indicating dysphagia or aspiration should receive a full clinical assessment of their swallowing ability by an S-LP. 21 Updated January 23, 2014 Page 3 of 8

4 TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) /Activities All patients with stroke should be screened using a validated tool to determine if they have a history of or risk factors for depression. Patients identified as being at risk of depression during screening should be referred to a health care professional with expertise in diagnosis and management of depression in stroke. 22 All patients with stroke should be screened at admission for risk of falls by an experience clinician. This screening should include comprehensive interprefessional assessment of medical functional history and examination of mobility, vision, perception, cognition, and cardiovasulcar status. Based on assessment, an individualized fall-prevention strategy should be implemented. 23 All stroke patients with vascular risk factors should be considered at high risk of vascular cognitive impairment and should be assessed for screened for cognitive impairment using the Montreal Cognitive Assessment. Patients with identified cognitive impairments should receive additional cognitive or neuropsychological assessments to guide management. 24 Persons with stroke should receive, through an individualized treatment plan, a minimum of three hours of direct task-specific therapy by the interprofessional stroke team for a minimum of six (OSN Stroke Reference Group) days per week. 25 Resources and processes to enable persons with stroke to access the appropriate type and intensity of rehabilitation services throughout their stay, including weekends when required 26 (i.e. while ensuring flexibility in scheduling persons with stroke, the ratio for direct to indirect therapy time should be 80:20). All patients with should begin rehabilitation therapy within an active and complex stimulating environment. 27 Therapy should include repetitive and intense use of novel tasks that use the involved limb during functional tasks and activities. 28 The team should promote the practice of skills gained in therapy into the daily routine Ratio for direct to indirect therapy time should be 80:20. (year 1) Staffing ratios should support, at minimum, the amount of therapy recommended. 31 (year 1) Protocols and strategies to prevent complications and the recurrence of stroke developed and communicated to all staff. 32 (year 2) Change in functional status scores (FIM Instrument) from inpatient rehabilitation admission to discharge. Average hours per day of direct therapy provided by the interprofessional stroke team. Average days per week of direct therapy provided by the Updated January 23, 2014 Page 4 of 8

5 TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) /Activities for persons with stroke. 29 Therapy to promote motor and physical recovery should be provided according to the best practice recommendations i.e. SCORE recommendations for upper and lower limb post-stroke management 30 (Appendix A). interprofessional stroke team. TRANSITIONS To support transitions between care environments, persons with stroke and their families/caregivers should be provided with information, education, training, emotional support and community services specific to the transition they are undergoing. 33 Healthcare providers to take responsibility for person-centred continuity of care as persons with stroke (and their families/caregivers) transition to the next point of care. This can be achieved through: Better understanding of the system as a whole (Transition Improvement for Continuity of Care (TICC) 34 ) Strengthening relationships with other areas of the care continuum. Creating an infrastructure to communicate with other healthcare providers (e.g. TICC My Stroke Passport and Knowing Each Other s Work). Ensuring support for persons with stroke and their families/caregivers (e.g. TICC Peers Fostering Hope). Support for persons with stroke and their families/caregivers during transitions also include 35 : Written discharge instructions. Access to a contact person in the hospital or community (designated case manager or system navigator) for post-discharge queries. Access to and advice from health and social service organizations (e.g. through single points of access to all organizations). Referrals to community agencies such as peer support groups or peer survivor visiting programs (TICC Peers Fostering Hope). Established process for transferring patientrelated information. This includes an up-to-date care plan for persons with stroke and their families/caregivers, which defines ongoing medical, rehabilitation, psychosocial and functional needs in a culturally appropriate format. 36 (year 2) Patient-mediated communication tool (TICC My Stroke Passport) (year 3-5). Healthcare provider framework for clinical handover (TICC Knowing Each Other s Work) (year 3-5). Healthcare provider conversation resource (CR Trigger tool). 37 (year 3-5) Proportion of persons with stroke that have utilized the TICC Stroke Passport. Patient and family satisfaction (NRC-Picker). Conversation/self-management resources established for persons with stroke and their families/caregivers (e.g. CR CATT). 38 (year 3-5) Discharge planning Discharge plans should be initiated as soon as possible after the person with stroke is admitted to hospital. 39 Effective discharge planning is essential for smooth transitions through the continuum of stroke care. Delayed or incomplete planning leads to prolonged hospital stays and an increased risk of adverse events following discharge. A process should be established to ensure that persons with stroke and their families/caregivers are involved in the development of their care plan, which includes transition management. Discharge planning discussions should be Protocols and pathways for stroke care along the continuum that address discharge planning. (year 1) Strong relationships among healthcare providers to facilitate safe and timely transitions. (year 3-5) Percentage of persons with stroke discharged to the community who receive a referral for ongoing rehab before discharge from hospital (core). Proportion of persons by stroke Updated January 23, 2014 Page 5 of 8

6 TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) Persons with stroke, families/caregivers and healthcare providers involved in each phase of care should all be involved in discharge planning to ensure effective and safe transitions. /Activities ongoing throughout hospitalization. Information about discharge issues and possible needs of persons with stroke following discharge should be provided soon after admission. Discharge planning activities should include interprofessional team meetings with persons with stroke and their families/caregivers, discharge and transition care plans, a pre-discharge needs assessment, and caregiver training. The CISCCoR Trigger tool could be used to support family and interprofessional team meetings. 40 Team to initiate referral to outpatient/community-based rehab as appropriate (E-Stroke Rehab Referral System). Access to self-management, caregiver training and appropriate support services to ensure a smooth transition. (year 3-5) Mechanisms should be in place to allow initiation of rehab referral from inpatients to outpatient/community-based rehab as appropriate. (year 2) Written discharge instructions for persons with stroke, their families/caregivers and their primary care providers should include: action plans, follow-up care and goals, significant interventions, prevention of complications, medications at discharge, plans for follow-up, functional abilities of the at time of transfer, and the delineation of respective roles and responsibilities of caregivers. severity (RPG) with stroke discharged to each disposition: o Home with services o Home without services o Outpatient/ambulatory care o Long term care Early Supported Discharge Persons with strokes should continue to have access to specialized stroke services after leaving the hospital, whether from acute care or inpatient rehabilitation. 41 Early supported discharge services provided by a well-resourced, coordinated, specialized interprofessional team can be utilized to decrease the length of stay on an inpatient rehabilitation stroke unit for select persons with stroke. Services could be home-based or ambulatory, but should maintain sufficient intensity of therapy to optimize outcomes and timely return to the community. Refer to Discharge Planning /Activities - see above. An established process or decision-making tool to delineate who would benefit most from early supported discharge (see for criteria). Protocols and processes for stroke care along the continuum that include early supported discharge and discharge planning throughout the stages of care. Proportion of persons with stroke who have participated in early supported discharge. Persons with mild to moderate disability may be offered early supported discharge if the following criteria are met: o They have access to an inhome/interprofessional community rehabilitation program, comprehensive caregiver training and/or support services from the date of transfer. o They can manage safely at home. Strong relationships among healthcare providers to facilitate safe and timely transitions. This could include enhanced coordination of services and communication with both inpatient rehabilitation and community providers., protocols, and resources for conducting home assessments by interprofessional team members soon after Updated January 23, 2014 Page 6 of 8

7 TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) Early supported discharge should not be offered to persons with moderate to severe stroke. /Activities the stroke. Access to appropriate education on selfmanagement, caregiver training and support services to ensure a smooth transition. (year 3-5) EDUCATION FOR PERSONS WITH STROKE AND THEIR FAMILIES/CAREGIVERS Education should include information sharing, teaching self-management skills and caregiver training. 42 Specific team members should be designated to provide and document education. 43 A process is in place to coordinate education for persons with stroke and their families/caregivers, which may include a designated lead. Education should be provided to persons with stroke and their families/caregivers and should be specific to the phase of recovery and appropriate to their readiness to receive education and needs. Education should cover all aspects of care and recovery. 44 Education should be interactive, timely, upto-date, provided in a variety of languages and formats (written, oral, aphasia friendly, group counselling approach), and specific to the needs and goals of persons with stroke and their families/caregivers. 45 Education that is specific, relevant, and meaningful to support achievement of personcentred goals. Consideration should be given to all domains of community re-engagement (health management, mobility, environment, communication, life roles, caregiver support, social network and financial). 46 (year 3-5) Proportion of persons with stroke with documentation of education (core). Patient and family satisfaction (NRC Picker). 1 Stroke Unit Trialists Collaboration Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke. Cochrane Database Systematic Review.; Langhorne P, Dey P, Woodman M, Kalra L, Wood-Dauphinee S, Patel N Hamrin E Is stroke unit care portable? A systematic review of the clinical trials. Age Ageing. Jul;34(4): Timeline relates to implementation of required elements to meet the recommendations. 3 Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update Ibid. Recommendation Ibid. Recommendation Ibid. Recommendation Canadian Stroke System. A Guide to the Implementation of Stroke Unit Care, 2009, p.9. 8 Ibid. 9 Saskatchewan Stroke Program, Definition of a Stroke Rehabilitation Program, Canadian Stroke System. A Guide to the Implementation of Stroke Unit Care 2009, p Ibid. p Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update Recommendation 5.2 (System Implications). 13 Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update Recommendation Teasell R, Foley N, Salter K, Bhogal SK, Jutai J and Speechley M. (2010). Evidence-based review of stroke rehabilitation, 13 h Edition. 15 Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update (System Implications). 16 Ibid. Recommendation Ibid. Recommendation Ibid. Recommendation 5.2 (System Implications). 19 Ibid. Recommendation Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update Recommendation Ibid. Recommendation Ibid. Recommendation Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update Recommendation 7.5 Updated January 23, 2014 Page 7 of 8

8 TORONTO STROKE FLOW INITIATIVE - Inpatient Rehabilitation Best Practice Guide (updated January 23, 2014) 24 Ibid. Recommendation Ibid. Recommendation Ibid. Recommendation 5.2 (System Implications). 27 Ibid. Recommendation Ibid. Recommendation Ibid. Recommendation Ibid. 5.4 and Ibid. Recommendation Ibid. Recommendation 5.2 (System Implications). 33 Ibid. Recommendation Transition Improvement for Continuity of Care, Toronto Stroke Networks. TICC consists of 3 components: Knowing Each Other s Work, My Stroke Passport, and Peers Fostering Hope. 35 Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update Recommendation Ibid. Recommendation CISCCoR Trigger Tool, 2010, developed by South East Toronto Stroke Network and Toronto West Stroke Network. 38 Community Re-Engagement Cue to Action Trigger Tool, developed by South East Toronto Stroke Network & Toronto West Stroke Network. 39 Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update Recommendation CISCCoR Trigger Tool, 2010,developed by South East Toronto Stroke Network and Toronto West Stroke Network. 41 Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update Recommendation Canadian Stroke Strategy, Canadian Best Practice for Stroke Care Update See Recommendation Ibid. 44 Ibid. 45 Ibid. 46 CISCCoR Trigger Tool, 2010,developed by South East Toronto Stroke Network and Toronto West Stroke Network. Updated January 23, 2014 Page 8 of 8

TORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013)

TORONTO STROKE FLOW INITIATIVE - Outpatient Rehabilitation Best Practice Recommendations Guide (updated July 26, 2013) Objective: To enhance system-wide performance and outcomes for persons with stroke in Toronto. Goals: Timely access to geographically located acute stroke unit care with a dedicated interprofessional team

More information

Dedicated Stroke Interprofessional Rehab Team. Mixed Rehab Unit. Dedicated Rehab Unit

Dedicated Stroke Interprofessional Rehab Team. Mixed Rehab Unit. Dedicated Rehab Unit Outpatient & Community I n p a t I e n t Stroke Rehab Definition Framework Institutional Setting Inpatient Rehab in Acute Care or Rehab Hospitals* Acute Care Integrated Specialized Units Transitional Care

More information

Communiqué 2: STROKE GUIDELINE IMPLEMENTATION. Toronto Central LHIN MSK/Stroke Implementation Group COMMUNIQUÉ 2: STROKE GUIDELINE IMPLEMENTATION 1

Communiqué 2: STROKE GUIDELINE IMPLEMENTATION. Toronto Central LHIN MSK/Stroke Implementation Group COMMUNIQUÉ 2: STROKE GUIDELINE IMPLEMENTATION 1 2 Communiqué 2: STROKE GUIDELINE IMPLEMENTATION Toronto Central LHIN MSK/Stroke Implementation Group COMMUNIQUÉ 2: STROKE GUIDELINE IMPLEMENTATION 1 IN DECEMBER 2012, THE TORONTO CENTRAL LHIN (TCLHIN)

More information

The Key Elements of Stroke Rehabilitation: Mark Bayley MD FRCPC

The Key Elements of Stroke Rehabilitation: Mark Bayley MD FRCPC The Key Elements of Stroke Rehabilitation: Mark Bayley MD FRCPC 1 Presenter Disclosure Information Presenter: Mark Bayley Associate Professor, University of Toronto and Medical Director, Neuro Rehabilitation,

More information

ISSUED BY: TITLE: ISSUED BY: TITLE: President

ISSUED BY: TITLE: ISSUED BY: TITLE: President CLINICAL PRACTICE GUIDELINE PROFESSIONAL PRACTICE TITLE: Stroke Care Rehabilitation Unit DATE OF ISSUE: 2005, 05 PAGE 1 OF 7 NUMBER: CPG 20-3 SUPERCEDES: New ISSUED BY: TITLE: Chief of Medical Staff ISSUED

More information

Stroke Rehab Across the Continuum of Care in Quinte Region

Stroke Rehab Across the Continuum of Care in Quinte Region Stroke Rehab Across the Continuum of Care in Quinte Region Adrienne Bell Smith Manager of Rehab Therapies QHC Karen Brown Manger Client Services, Hospital Access South East CCAC Disclosure of Potential

More information

Ontario Stroke System. Prepared by: Stroke Rehabilitation Evaluation Working Group Stroke Evaluation Advisory Committee May, 2007

Ontario Stroke System. Prepared by: Stroke Rehabilitation Evaluation Working Group Stroke Evaluation Advisory Committee May, 2007 Ontario Stroke System Stroke Rehabilitation Performance Measurement Manual Prepared by: Stroke Rehabilitation Evaluation Working Group Stroke Evaluation Advisory Committee May, 2007 Stroke Rehabilitation

More information

Stroke Rehabilitation Intensity Frequently Asked Questions

Stroke Rehabilitation Intensity Frequently Asked Questions Stroke Rehabilitation Intensity Frequently Asked Questions 1) What is the provincial definition of Rehabilitation Intensity? Rehabilitation Intensity 1 is: The amount of time the patient spends in individual,

More information

Hamilton Health Sciences Integrated Stroke Model of Care. Rhonda Whiteman, Stroke Best Practices Coordinator, Hamilton Health Sciences

Hamilton Health Sciences Integrated Stroke Model of Care. Rhonda Whiteman, Stroke Best Practices Coordinator, Hamilton Health Sciences Hamilton Health Sciences Integrated Stroke Model of Care Rhonda Whiteman, Stroke Best Practices Coordinator, Hamilton Health Sciences Integrated Stroke Model of Care Goals To provide a more comprehensive

More information

Importance of Integrating Stroke Rehabilitation Across the Continuum of Care

Importance of Integrating Stroke Rehabilitation Across the Continuum of Care Importance of Integrating Stroke Rehabilitation Across the Continuum of Care Dori Tooke, MHA, PT, CSCS Manager-Inpatient Rehab Program St. Luke s Medical Center Milwaukee, WI Disclosure Nothing to disclose

More information

THE IMPACT OF MOVING TO STROKE REHABILITATION BEST PRACTICES IN ONTARIO FINAL REPORT

THE IMPACT OF MOVING TO STROKE REHABILITATION BEST PRACTICES IN ONTARIO FINAL REPORT THE IMPACT OF MOVING TO STROKE REHABILITATION BEST PRACTICES IN ONTARIO FINAL REPORT Matthew Meyer, Christina O Callaghan, Linda Kelloway, Ruth Hall, Robert Teasell, Samantha Meyer, Laura Allen, Erik Leci;

More information

Waterloo Wellington CCAC Community Stroke Program

Waterloo Wellington CCAC Community Stroke Program Waterloo Wellington CCAC Community Stroke Program Stroke Collaborative 2014 October 27, 2014 Maria Fage, OT Reg. (Ont.) Manager, Client Services Map of Waterloo Wellington LHIN 2 Background Integration

More information

Appendix L: HQO Year 1 Implementation Priorities

Appendix L: HQO Year 1 Implementation Priorities Appendix L: HQO Year 1 Implementation Priorities Chronic Obstructive Pulmonary Disease (Source: COPD Chairs) Non-Invasive Positive Pressure Ventilation Early Ambulation If possible, seek patient preferences

More information

The following document was directed to the North East LHIN.

The following document was directed to the North East LHIN. The following document was directed to the North East LHIN. If you require any further details into the information presented here please feel free to contact Jenn Fearn, Regional Rehabilitation Coordinator,

More information

Rehabilitation Nurses: Champions for Optimizing Stroke Rehabilitation Across the Continuum of Care

Rehabilitation Nurses: Champions for Optimizing Stroke Rehabilitation Across the Continuum of Care Rehabilitation Nurses: Champions for Optimizing Stroke Rehabilitation Across the Continuum of Care Presenters Sandra Melchiorre RN, MN, ACNP, CNN (c) Regional Stroke Acute Care Advanced Practice Nurse,

More information

Summary Report. Moving to Best Practice. Southwestern Ontario Stroke Rehabilitation Action Planning Day November 28, 2006

Summary Report. Moving to Best Practice. Southwestern Ontario Stroke Rehabilitation Action Planning Day November 28, 2006 Southwestern Ontario Stroke Rehabilitation Action Planning Day November 28, 2006 Summary Report Moving to Best Practice Prepared by: Deborah Willems Southwestern Ontario Stroke Strategy January 29, 2007

More information

Enhancing Community and LTC Rehabilitation Services for Stroke Survivors: Improving the System of Care

Enhancing Community and LTC Rehabilitation Services for Stroke Survivors: Improving the System of Care Enhancing Community and LTC Rehabilitation Services for Stroke Survivors: Improving the System of Care The Discharge Link A Cross - Continuum Partnership South East Ontario Population ~ 525,000 20,000

More information

Cardiovascular Health & Stroke SCN Project Overview

Cardiovascular Health & Stroke SCN Project Overview Cardiovascular Health & Stroke SCN Project Overview Background The Alberta Provincial Stroke Strategy (APSS) has been successful in enhancing rural and urban stroke care across the province with improved

More information

Outpatient/Ambulatory Rehab. Dedicated Trans-disciplinary Team (defined within Annotated References)

Outpatient/Ambulatory Rehab. Dedicated Trans-disciplinary Team (defined within Annotated References) CARDIAC The delivery of Cardiac Rehab is unlike most other rehab populations. The vast majority of patients receive their rehab in outpatient or community settings and only a small subset requires an inpatient

More information

ALBERTA PROVINCIAL STROKE STRATEGY (APSS)

ALBERTA PROVINCIAL STROKE STRATEGY (APSS) ALBERTA PROVINCIAL STROKE STRATEGY (APSS) Stroke Systems of Care Key Components APSS Pillar Recommendations March 28, 2007 1 The following is a summary of the key components and APSS Pillar recommendations

More information

Timing it Right to Support Families as they Transition

Timing it Right to Support Families as they Transition Timing it Right to Support Families as they Transition Jill Cameron, PhD Canadian Institutes of Health Research New Investigator Assistant Professor Adjunct Scientist, Toronto Rehabilitation Institute

More information

Best Practice Recommendations for Inpatient Stroke Care: Rationale and Evidence for Integrated Stroke Units in North Simcoe Muskoka LHIN

Best Practice Recommendations for Inpatient Stroke Care: Rationale and Evidence for Integrated Stroke Units in North Simcoe Muskoka LHIN Best Practice Recommendations for Inpatient Stroke Care: Rationale and Evidence for Integrated Stroke Units in North Simcoe Muskoka LHIN Physician Education Session May 24, 2013 Dr. Mark Bayley,, Cheryl

More information

How many RCTs in Stroke Rehab?

How many RCTs in Stroke Rehab? Evidence Based Stroke Rehabilitation: Maximizing Recovery and Improving Outcomes Robert Teasell MD FRCPC Professor and Chair Chief Physical Medicine & Rehabilitation St. Joseph s Health Care London University

More information

The Impact of Moving to Stroke Rehabilitation Best Practices in Ontario

The Impact of Moving to Stroke Rehabilitation Best Practices in Ontario The Impact of Moving to Stroke Rehabilitation Best Practices in Ontario Matthew Meyer Project Coordinator, Stroke Rehabilitation Best Practices Ontario Stroke Network Overview Discuss: 1. Current State:

More information

CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia

CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia V. Service Delivery Service Delivery and the Treatment System General Principles 1. All patients should have access to a comprehensive continuum

More information

PURPOSE OF THE SELF-ASSESSMENT TOOLS:

PURPOSE OF THE SELF-ASSESSMENT TOOLS: Geriatric Rehab Definitions Framework Self-Assessment Tool Outpatient/Ambulatory Geriatric Rehab INTRODUCTION: In response to a changing rehab landscape in which rehabilitation is offered in many different

More information

AlphaFIM Instrument Too ol1 Mild Stroke Project (Part II) Report

AlphaFIM Instrument Too ol1 Mild Stroke Project (Part II) Report 1 AlphaFIM Instrument Tool 1 Mild Stroke Project (Part II) Report Prepared by: Carmel Forrestal Regional Stroke Rehab Coordinator 1 The FIM instrument and AlphaFIM instrument referenced herein are the

More information

Rehabilitation. Care

Rehabilitation. Care Rehabilitation Care Bruyère Continuing Care is the champion of well-being for aging Canadians and those requiring Continuing Care, helping them to become and remain as healthy and independent as possible

More information

STROKE REHABILITATION RESOURCE GUIDE

STROKE REHABILITATION RESOURCE GUIDE STROKE REHABILITATION RESOURCE GUIDE INTRODUCTION The intent of the Stroke Rehabilitation Resource Guide is to enable stroke care providers seeking information related to the rehabilitation of the stroke

More information

Discharge Planning. Home Assess / Treat. inpatient CCC (active/ltld) rehab = ALC Designation LTC. Admit

Discharge Planning. Home Assess / Treat. inpatient CCC (active/ltld) rehab = ALC Designation LTC. Admit DISCHARGE PLANNING GUIDELINES FOR INPATIENT REHABILITATION The Discharge Planning Guidelines for Inpatient Rehabilitation have been developed by the GTA Rehab Network s Patient Access and Flow Committee

More information

Stroke Rehabilitation Triage Severe Strokes

Stroke Rehabilitation Triage Severe Strokes The London Stroke Rehab Data Base Project Robert Teasell MD FRCPC Professor and Chair-Chief Department of Phys Med Rehab London Ontario Retrospective Data Bases In stroke rehab limited funding for clinical

More information

Fall 2013. A progress report on improving rehabilitative care in Waterloo Wellington

Fall 2013. A progress report on improving rehabilitative care in Waterloo Wellington Fall 2013 A progress report on improving rehabilitative care in Waterloo Wellington The Waterloo Wellington Rehabilitative Care Council Improving rehabilitative care in Waterloo Wellington, fall 2013,

More information

SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY

SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY SECTION B PART 1 - SERVICE SPECIFICATIONS Service specification number Service Commissioner Lead Provider Lead Period Date of

More information

Marina Richardson, M.Sc. Deb Willems, BSc.PT David Ure, OT Robert Teasell, MD FRCPC

Marina Richardson, M.Sc. Deb Willems, BSc.PT David Ure, OT Robert Teasell, MD FRCPC Assessing the Impact of Southwestern Ontario s Community Stroke Rehabilitation Teams: An Economic Analysis Presenters: Laura Allen, M.Sc. (cand.) Matthew Meyer, Ph.D (cand.) Marina Richardson, M.Sc. Deb

More information

Hamilton Health Sciences Acquired Brain Injury Program

Hamilton Health Sciences Acquired Brain Injury Program Overview of Program The Acquired Brain Injury (ABI) Program at the Regional Rehabilitation Centre, Hamilton General Hospital serve the rehabilitation needs of adults with acquired brain injuries and their

More information

Ontario Stroke Network. Regional Economic Overview South West LHIN

Ontario Stroke Network. Regional Economic Overview South West LHIN Ontario Stroke Network Regional Economic Overview South West LHIN Matthew Meyer, Andrew McClure, Christina O Callaghan, Linda Kelloway, Paula Gilmore, Deb Willems, Dr. Robert Teasell 9/19/2013 Table of

More information

Stroke Rehabilitation

Stroke Rehabilitation Stroke Rehabilitation Robert Teasell MD FRCPC Professor and Chair-Chief Dept Physical Medicine and Rehabilitation Schulich School of Medicine University of Western Ontario Lawson Health Research Institute

More information

Theme 3: Accessing ongoing post stroke care in the community

Theme 3: Accessing ongoing post stroke care in the community Break Out Session TSN Annual Forum Dec 03 2013 Theme 3: Accessing ongoing post stroke community a) Within your organizations, what are you doing well to collaborate and link your patients to ongoing -

More information

Transforming Patient Flow, Improving Patient Care

Transforming Patient Flow, Improving Patient Care Transforming Patient Flow, Improving Patient Care Transformation by Design (TbyD) Dr. Peter Nord, VP, CMO, Chief of Staff Thelma Horwitz, Director, Quality and Process Improvement Heidi Hunter, Quality

More information

How To Plan A Rehabilitation Program

How To Plan A Rehabilitation Program Project Plan to Rehabilitation Service Connecting and Collaborating in the Continuity of Care in Rehabilitation Presented By: Arlene Whitehead, May 31, 2011 Rehabilitation Collaborative Overview OUTLINE

More information

North East LHIN Stroke Care Review - 2013. Northeastern Ontario Stroke Network Steering Committee

North East LHIN Stroke Care Review - 2013. Northeastern Ontario Stroke Network Steering Committee North East LHIN Stroke Care Review - 2013 Northeastern Ontario Stroke Network Steering Committee December 20 th, 2013 Table of Contents Item Page Executive Summary 1 A. Regional Stroke Review 2 B. Major

More information

Good Samaritan Inpatient Rehabilitation Program

Good Samaritan Inpatient Rehabilitation Program Good Samaritan Inpatient Rehabilitation Program Living at your full potential. Welcome When people are sick or injured, our goal is their maximum recovery. We help people live to their full potential.

More information

Community Stroke Rehabilitation Model May, 2013

Community Stroke Rehabilitation Model May, 2013 Community Stroke Rehabilitation Model May, 2013 Community Stroke Rehabilitation Model May 2013 i Table of Contents EXECUTIVE SUMMARY... ii BACKGROUND...1 HNHB LHIN GEOGRAPHY AND POPULATION...1 STROKE AND

More information

Profile: Kessler Patients

Profile: Kessler Patients Profile: Kessler Patients 65 Breakthrough Years Kessler Institute has pioneered the course of medical rehabilitation since 1948. Today, as the nation s largest single rehabilitation hospital, we continue

More information

Implementation of an Interprofessional Team Approach to Stroke Rehabilitation Among Stroke Survivors Using Home Care: Evaluation and Lessons Learned

Implementation of an Interprofessional Team Approach to Stroke Rehabilitation Among Stroke Survivors Using Home Care: Evaluation and Lessons Learned Implementation of an Interprofessional Team Approach to Stroke Rehabilitation Among Stroke Survivors Using Home Care: Evaluation and Lessons Learned Maureen Markle-Reid, RN, MScN, PhD Associate Professor

More information

Rehabilitation Services. Hospital Pavilion North, 5 th Floor 443-481-4100 Monday-Friday 0800-1630 Saturday/Sunday 0700-1930

Rehabilitation Services. Hospital Pavilion North, 5 th Floor 443-481-4100 Monday-Friday 0800-1630 Saturday/Sunday 0700-1930 Rehabilitation Services Hospital Pavilion North, 5 th Floor 443-481-4100 Monday-Friday 0800-1630 Saturday/Sunday 0700-1930 Department Overview Rehabilitation Services include physical therapy (PT), occupational

More information

National Stroke Association s Guide to Choosing Stroke Rehabilitation Services

National Stroke Association s Guide to Choosing Stroke Rehabilitation Services National Stroke Association s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you: Re-learn basic skills

More information

Complex Outpatient. Injury. Rehab. Integrated, evidence-based rehab that supports a timely return to home, life, work or school

Complex Outpatient. Injury. Rehab. Integrated, evidence-based rehab that supports a timely return to home, life, work or school Complex Outpatient Injury Rehab Integrated, evidence-based rehab that supports a timely return to home, life, work or school Toronto Rehabilitation Institute At Toronto Rehab, our goal is to advance rehabilitation

More information

Canadian Stroke Guidelines for Rehabilitation

Canadian Stroke Guidelines for Rehabilitation Canadian Stroke Guidelines for Rehabilitation Robert Teasell MD FRCPC Professor Physical Medicine and Rehabilitation Schulich School of Medicine Western University London, Ontario, Canada In theory there

More information

STROKE REHABILITATION RESOURCE GUIDE

STROKE REHABILITATION RESOURCE GUIDE STROKE REHABILITATION RESOURCE GUIDE INTRODUCTION The intent of the Stroke Rehabilitation Guide is to enable stroke care providers seeking information related to the rehabilitation of the stroke survivor

More information

Institutional Setting. Home / Residential

Institutional Setting. Home / Residential Outpatient & Community I n p a t I e n t Spinal Cord Injury Rehab Definition Framework Institutional Setting Inpatient Rehab in Acute Care or Rehab Hospitals* Acute Care Integrated Specialized Units Transitional

More information

How To Run An Acquired Brain Injury Program

How To Run An Acquired Brain Injury Program ` Acquired Brain Injury Program Regional Rehabilitation Centre at the Hamilton General Hospital Table of Contents Page Introduction... 3-4 Acquired Brain Injury Program Philosophy... 3 Vision... 3 Service

More information

Patient Flow and Care Transitions Strategy 2013-2018. Updated September 2014

Patient Flow and Care Transitions Strategy 2013-2018. Updated September 2014 Patient Flow and Care Transitions Strategy 2013-2018 Updated Introduction Island Health s Patient Flow and Care Transitions 2013-2018 Strategy builds on the existing work within the organization to address

More information

What do these stories illustrate about ER/ALC issue?

What do these stories illustrate about ER/ALC issue? What do these stories illustrate about ER/ALC issue? Maximizing the Impact of Rehab on Provincial Priority Issues Mark Bayley, MD, FRCPC Medical Director, Neuro Rehabilitation Program, Toronto Rehab and

More information

Implementing a clustered acute stroke unit at a community hospital improves patient care

Implementing a clustered acute stroke unit at a community hospital improves patient care Implementing a clustered acute stroke unit at a community hospital improves patient care Linda Dykes, BScPT Manager, Sarnia Lambton District Stroke Centre Krista Steeves, BHScPT Physiotherapist, Bluewater

More information

INTERPROFESSIONAL LEARNING OBJECTIVES FOR STROKE CARE INTRODUCTION

INTERPROFESSIONAL LEARNING OBJECTIVES FOR STROKE CARE INTRODUCTION INTERPROFESSIONAL LEARNING OBJECTIVES FOR STROKE CARE INTRODUCTION Supporting Interprofessional Education through Shared Learning Opportunities APRIL 2007 Interprofessional Learning Objectives for Stroke

More information

Implementing Evidence Based Community Stroke Services

Implementing Evidence Based Community Stroke Services Implementing Evidence Based Community Stroke Services Dr Rebecca Fisher & Professor Marion Walker University of Nottingham () Damian Jenkinson & Ian Golton (NHS Stroke Improvement Programme) A partnership

More information

Clinical Guidelines for Stroke Management

Clinical Guidelines for Stroke Management Stop stroke. Save lives. End suffering. Clinical Guidelines for Stroke Management quick guide for physiotherapy This summary is an implementation tool designed to raise the awareness of the recommendations

More information

Post-Acute Rehab: Community Re-Entry After Stroke? Sheldon Herring, Ph.D. Roger C. Peace Rehab Hospital Greenville Hospital System

Post-Acute Rehab: Community Re-Entry After Stroke? Sheldon Herring, Ph.D. Roger C. Peace Rehab Hospital Greenville Hospital System Post-Acute Rehab: Community Re-Entry After Stroke? Sheldon Herring, Ph.D. Roger C. Peace Rehab Hospital Greenville Hospital System 2014 Neurocognitive Deficits After Stroke: The Hidden Disability Sheldon

More information

Patient s Handbook. Provincial Rehabilitation Unit ONE ISLAND HEALTH SYSTEM ONE ISLAND FUTURE 11HPE41-30364

Patient s Handbook. Provincial Rehabilitation Unit ONE ISLAND HEALTH SYSTEM ONE ISLAND FUTURE 11HPE41-30364 Patient s Handbook Provincial Rehabilitation Unit ONE ISLAND FUTURE ONE ISLAND HEALTH SYSTEM 11HPE41-30364 REHABILITATION EQUIPMENT USED ON UNIT 7 During a patient s stay on Unit 7, various pieces of

More information

Faculty/Presenter Disclosure

Faculty/Presenter Disclosure The Long-Term Rehabilitation Management of Stroke Patients Robert Teasell MD FRCPC Professor, Dept PM&R Schulich School of Medicine University of Western Ontario CFPC CoI Templates: Slide 1 Faculty/Presenter

More information

Complex Continuing Care Restorative Care (Combined Functional Enhancement and Restorative Care Programs)

Complex Continuing Care Restorative Care (Combined Functional Enhancement and Restorative Care Programs) Complex Continuing Care Restorative Care (Combined Functional Enhancement and Restorative Care Programs) Description: The Restorative Care program provides a moderate to low intensity goal-oriented rehabilitation

More information

Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives

Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives Improving access to psychological therapies for people with severe and enduring mental health problems: rehabilitation psychiatrists perspectives Dr Helen Killaspy Reader and honorary consultant in rehabilitation

More information

Rehabilitation Stroke Services Framework Summary 2013

Rehabilitation Stroke Services Framework Summary 2013 Rehabilitation Stroke Services Framework Summary 2013 The Rehabilitation Stroke Services Framework is designed to enable the delivery and monitoring of best practice stroke care across Australia. Rehabilitation

More information

How To Care For A Disabled Person

How To Care For A Disabled Person Henry Ford Macomb Hospitals Inpatient Rehabilitation Patient and Family Handbook Welcome At Henry Ford Macomb Hospitals, our goal is to help you become as independent as possible while achieving your

More information

Statement of Purpose for the Strategic Plan

Statement of Purpose for the Strategic Plan Contributors: Elena Espirtu, OTR/L Mary Gollinger, MS, CRRN, RN Renu Mahajan, MD Sriramjini Muthukrishnan, MD Keir Ringquist, PT, GCS David Miller Mamie Kutame, MSW William Kettlewell, RN Kimberly Zimmerman,

More information

Mobile Rehabilitation Team St Vincent s Style. Dr Shari Parker Rehabilitation Physician

Mobile Rehabilitation Team St Vincent s Style. Dr Shari Parker Rehabilitation Physician Mobile Rehabilitation Team St Vincent s Style Dr Shari Parker Rehabilitation Physician Drivers for Change 1. Pressure on beds, bed blocks 2. Evidence for Early Rehabilitation 3. The problem of Deconditioning

More information

Rehabilitation Services at Hospitals 3.08. Chapter 3 Section. Background DESCRIPTION OF REHABILITATION ELIGIBILITY FOR REHABILITATION

Rehabilitation Services at Hospitals 3.08. Chapter 3 Section. Background DESCRIPTION OF REHABILITATION ELIGIBILITY FOR REHABILITATION Chapter 3 Section 3.08 Ministry of Health and Long-Term Care Rehabilitation Services at Hospitals Background DESCRIPTION OF REHABILITATION Rehabilitation services in Ontario generally provide support to

More information

Restorative Care. Policy, Procedures and Training Package

Restorative Care. Policy, Procedures and Training Package Restorative Care Policy, Procedures and Training Package Release Date: December 17, 2010 Disclaimer The Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS) Long-Term Care Homes Act

More information

An Economic Model for Stroke Rehabilitation in Ontario: Mapping Resource Availability and Patient Needs

An Economic Model for Stroke Rehabilitation in Ontario: Mapping Resource Availability and Patient Needs An Economic Model for Stroke Rehabilitation in Ontario: Mapping Resource Availability and Patient Needs Matthew J. Meyer, Shelialah Pereira, Andrew McClure, Norine Foley, Katherine Salter, Deborah Willems,

More information

ACUTE CARE TO REHABILITATION

ACUTE CARE TO REHABILITATION ACUTE CARE TO REHABILITATION JONATHAN P. QUEVEDO, M.D. JFK-JOHNSON REHABILITATION HOSPITAL PRESENTER DISCLOSURE INFORMATION JONATHAN P. QUEVEDO M.D. ACUTE CARE TO REHABILITATION FINANCIAL DISCLOSURE EMPLOYED

More information

Objectives. Workshop Organization. Reality Check: Trends in Ontario. Ontario Stroke Rehab 2005/2006

Objectives. Workshop Organization. Reality Check: Trends in Ontario. Ontario Stroke Rehab 2005/2006 Objectives Rehabilitation of Severe Strokes: Making the Tough Decisions Robert Teasell MD FRCPC Professor and Chair Chief Depart of Phys Med Rehab Parkwood Hospital Understand the impact of stroke severity

More information

Brief, Evidence Based Review of Inpatient/Residential rehabilitation for adults with moderate to severe TBI

Brief, Evidence Based Review of Inpatient/Residential rehabilitation for adults with moderate to severe TBI Brief, Evidence Based Review of Inpatient/Residential rehabilitation for adults with moderate to severe TBI Reviewer Peter Larking Date Report Completed 7 October 2011 Important Note: This brief report

More information

Complex Care Planning in the Emergency Department: Demonstrating Rehabilitation Contributions

Complex Care Planning in the Emergency Department: Demonstrating Rehabilitation Contributions Complex Care Planning in the Emergency Department: Demonstrating Rehabilitation Contributions CAOT Conference 2016 Inspired for Higher Summits Banff, AB No conflict of interest Project Team all from Sunnybrook

More information

STROKE REHABILITATION SURVEY

STROKE REHABILITATION SURVEY STROKE REHABILITATION SURVEY INDIANA STROKE PREVENTION TASK FORCE PRESENTED BY VICKI SCOTT, MS, CTRS RECREATIONAL THERAPIST TASK FORCE MEMBER BACKGROUND Stroke is the third leading cause of death in all

More information

Homeward Bound. Amanda Melvin, MSW Emily Hartman, BSN, RN Tiffany Curtis, BSN, RN, CRRN Cindy Regan, MSN, RN - BC

Homeward Bound. Amanda Melvin, MSW Emily Hartman, BSN, RN Tiffany Curtis, BSN, RN, CRRN Cindy Regan, MSN, RN - BC Homeward Bound Amanda Melvin, MSW Emily Hartman, BSN, RN Tiffany Curtis, BSN, RN, CRRN Cindy Regan, MSN, RN - BC Objectives Identify and differentiate the levels of stroke rehabilitation care. Identify

More information

20 Years in Stroke Rehabilitation: Trials, Tribulations and Tomorrow

20 Years in Stroke Rehabilitation: Trials, Tribulations and Tomorrow 20 Years in Stroke Rehabilitation: Trials, Tribulations and Tomorrow Julie Bernhardt Assoc Prof, Director AVERT Very Early Rehabilitation Program, National Stroke Research Institute and School of Physiotherapy,

More information

Shepherd Center is a world-renowned provider of comprehensive, specialized rehabilitation for people with spinal cord injury, brain injury or stroke.

Shepherd Center is a world-renowned provider of comprehensive, specialized rehabilitation for people with spinal cord injury, brain injury or stroke. Shepherd Center is a world-renowned provider of comprehensive, specialized rehabilitation for people with spinal cord injury, brain injury or stroke. Table of Contents 1 HOPE is HERE 2 Why choose Shepherd

More information

Provincial Rehabilitation Unit. Patient Handbook

Provincial Rehabilitation Unit. Patient Handbook Provincial Rehabilitation Unit Patient Handbook ONE ISLAND FUTURE ONE ISLAND HEALTH SYSTEM Welcome to Unit 7, the Provincial Rehabilitation Unit. This specialized 20 bed unit is staffed by an interdisciplinary

More information

Pilot Projects Year II

Pilot Projects Year II STROKE CARE IN LONG-TERM CARE FACILITIES AND THE COMMUNITY Pilot Projects Year II March 2003 Report prepared by Ilsa Blidner Consulting Inc. Contents Background... 1 Stroke Strategy Initiatives in the

More information

Rehabilitation PSU Speech-Language Pathology Services

Rehabilitation PSU Speech-Language Pathology Services Rehabilitation PSU Speech-Language Pathology Services Age of Population: Birth to 18 years of age, check description below for age range per program and referral process Languages: all services are available

More information

SAM KARAS ACUTE REHABILITATION CENTER

SAM KARAS ACUTE REHABILITATION CENTER SAM KARAS ACUTE REHABILITATION CENTER 1 MEDICAL CARE Sam Karas Acute Rehabilitation The Sam Karas Acute Rehabilitation Center is a comprehensive and interdisciplinary inpatient unit. Medical care is directed

More information

Mount Sinai Rehabilitation Center. 2014 Outcomes. Mount Sinai Rehabilitation Center 2014 Outcomes

Mount Sinai Rehabilitation Center. 2014 Outcomes. Mount Sinai Rehabilitation Center 2014 Outcomes Mount Sinai Rehabilitation Center 2014 Outcomes Mount Sinai Rehabilitation Center 2014 Outcomes TABLE OF CONTENTS A Message from the Chair... 3 About Our Programs. 4-5 Inpatient Rehabilitation. 6-12 Outpatient

More information

Using Objective Measures to Facilitate Rehabilitation Referral

Using Objective Measures to Facilitate Rehabilitation Referral Using Objective Measures to Facilitate Rehabilitation Referral Mark Bayley MD, FRCPC Medical Director, Neuro Rehabilitation Program, Toronto Rehabilitation Institute Associate Professor, Division of Physiatry,

More information

Health Professionals who Support People Living with Dementia

Health Professionals who Support People Living with Dementia Clinical Access and Redesign Unit Health Professionals who Support People Living with Dementia (in alphabetical order) Health Professional Description Role in care of people with dementia Dieticians and

More information

REHABILITATION SERVICES

REHABILITATION SERVICES REHABILITATION SERVICES Table of Contents GENERAL... 2 TERMS AND ABBREVIATIONS... 2 PRIOR AUTHORIZATION REQUIREMENTS FOR MEDICAID REIMBURSEMENT OF INPATIENT REHABILITATION SERVICES (Updated 4/1/11)...

More information

Research Summary. Towards Earlier Discharge, Better Outcomes, Lower Cost: Stroke Rehabilitation in Ireland. September 2014

Research Summary. Towards Earlier Discharge, Better Outcomes, Lower Cost: Stroke Rehabilitation in Ireland. September 2014 Towards Earlier Discharge, Better Outcomes, Lower Cost: Stroke Rehabilitation in Ireland September 2014 Research Summary Report prepared for the Irish Heart Foundation by the Economic and Social Research

More information

Patient Services Manual

Patient Services Manual Senior Director, and Chief Nursing Executive Policy General Rehabilitation Page 1 of 7 The Waterloo Wellington Local Health Integration Network (LHIN) recommends access to general rehabilitation beds in

More information

Amputation Rehabilitation Center

Amputation Rehabilitation Center Amputation Rehabilitation Center AT MossRehab Since 1959, MossRehab has provided our patients with a breadth of clinical expertise unrivaled in the region. Within our extensive system you ll find: Experienced

More information

Behaviour Management: Partnering To Bridge The Continuum. Presented by: Nancy Boaro, MN, CNN(C), CRN(C) Karey-Anne Fannon, BA, BST, RRP.

Behaviour Management: Partnering To Bridge The Continuum. Presented by: Nancy Boaro, MN, CNN(C), CRN(C) Karey-Anne Fannon, BA, BST, RRP. Behaviour Management: Partnering To Bridge The Continuum Presented by: Nancy Boaro, MN, CNN(C), CRN(C) Karey-Anne Fannon, BA, BST, RRP Objectives Review some of the behaviours exhibited by patients with

More information

2016 MEDICAL REHABILITATION PROGRAM DESCRIPTIONS

2016 MEDICAL REHABILITATION PROGRAM DESCRIPTIONS 2016 MEDICAL REHABILITATION PROGRAM DESCRIPTIONS Contents Comprehensive Integrated Inpatient Rehabilitation Program... 2 Outpatient Medical Rehabilitation Program... 2 Home and Community Services... 3

More information

A collaborative model for service delivery in the Emergency Department

A collaborative model for service delivery in the Emergency Department A collaborative model for service delivery in the Emergency Department Regional Geriatric Program of Toronto, December 2009 Background Seniors over the age of 75 years now have the highest Emergency Department

More information

Attachment A Minnesota DHS Community Service/Community Services Development

Attachment A Minnesota DHS Community Service/Community Services Development Attachment A Minnesota DHS Community Service/Community Services Development Applicant Organization: First Plan of Minnesota Project Title: Implementing a Functional Daily Living Skills Assessment to Predict

More information

NICE: REHABILITATION AFTER STROKE GUIDELINE. Sue Thelwell Stroke Services Co-ordinator UHCW NHS Trust

NICE: REHABILITATION AFTER STROKE GUIDELINE. Sue Thelwell Stroke Services Co-ordinator UHCW NHS Trust NICE: REHABILITATION AFTER STROKE GUIDELINE Sue Thelwell Stroke Services Co-ordinator UHCW NHS Trust Content About me! NICE Rehabilitation after Stroke to include background, remit and scope, guideline

More information

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Discharge Planning

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Discharge Planning DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services ICN 908184 October 2014 This booklet was current at the time it was published or uploaded onto the web. Medicare policy

More information

Commissioning Support for London. Stroke rehabilitation guide: supporting London commissioners to commission quality services in 2010/11

Commissioning Support for London. Stroke rehabilitation guide: supporting London commissioners to commission quality services in 2010/11 Commissioning Support for London Stroke rehabilitation guide: supporting London commissioners to commission quality services in 2010/11 Contents Executive summary 4 1 Introduction 7 1.1 Healthcare for

More information

STROKE REHABILITATION INTENSITY:

STROKE REHABILITATION INTENSITY: STROKE REHABILITATION INTENSITY: Shelley Huffman Stroke Rehabilitation Coordinator Stroke Network of Southeastern Ontario Janine Theben Stroke Rehabilitation Coordinator West GTA Stroke Network Rehab Intensity

More information

Strathalbyn and District Health Service: How a Multidisciplinary team Works?

Strathalbyn and District Health Service: How a Multidisciplinary team Works? Strathalbyn and District Health Service: How a Multidisciplinary team Works? Merridy Chester (Clinical Services Coordinator) Brett Webster (Advanced Clinical Lead OT) Outline Who we are - multidisciplinary

More information

AMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Verificatoin Criterea EFFECTIVE JANUARY 1, 2015. Criterion. Level (1 or 2) Number

AMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Verificatoin Criterea EFFECTIVE JANUARY 1, 2015. Criterion. Level (1 or 2) Number Criterion AMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Criterion Level (1 or 2) Number Criterion BURN CENTER ADMINISTRATION 1. The burn center hospital is currently accredited by The

More information

New Technologies and Their Role in Enhancing Neurological Recovery

New Technologies and Their Role in Enhancing Neurological Recovery REHABILITATION CARE 2014: under the ACA Patient Centered Medical Home for Persons with Disability: Acute Neurology, Medicine, Surgery services seamlessly blending into Acute inpatient Rehabilitation Ambulatory

More information