Integrated Approach to Stroke Rehabilitation for Mild Stroke Patients

Participating Organization(s): 1to1 Rehab, West GTA Stroke Network, William Osler Health System, Central West LHIN Home and Community Care


Using hospital rehabilitation therapists (occupational therapy, physiotherapy, speech language pathology) and therapy assistants in the community (physiotherapy, occupational therapy, communicative disorders), the participating partners piloted an Integrated Stroke Rehabilitation Program for mild stroke patients (Alpha FIM >80). Prior to this initiative, patients waited six inpatient days to access intensive stroke therapy, with an eight to 24 week wait for therapy. 

Each patient had an earlier hospital discharge, a therapeutic plan and intensive intervention up to five days per week, with therapy assistants at home. Patient-centred goals (e.g. memory/thinking/concentration, communication, return to work, return to community mobility, activities of daily living/instrumental activities of daily living/activation, physical strength/ balance/endurance, physical upper/lower extremity/facial symmetry function, vision, reading and writing) drove interventions. 

Outcomes achieved included a decreased acute length of stay by three days, a 12 per cent decrease in patients admitted to inpatient rehab, an eight-week decrease in wait time for specialized stroke rehabilitation services, and a three to four point improvement in the Canadian Occupational Performance Measure (COPM©) addressing patient goals. The pilot project, with an initial 50 stroke patients, also resulted in costs savings, a streamlined process, and 100 per cent patient satisfaction. Participating stroke patients achieved excellent therapeutic outcomes. This program has been continued with annual funding.

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