Referrer and service provider beliefs and attitudes towards rehabilitation in the home; factors related to utilisation of Early Supported Discharge

Abstract

Differences in views held by referrers and ESD service providers were identified in this study that could lead to inconsistencies in patient selection for, and under-utilization of, ESD services. Improved communication between referrers and ESD service providers, for instance attendance of RITH staff at inpatient team meetings, could ameliorate some of these misconceptions. On-going education of referrers about service capability is essential to ensure timely transfer of appropriate clients to ESD services.

Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact

“…This is in line with practices in other services offering Early Supported Discharge interventions both in the UK 17 and internationally. 18 In addition, and echoing the findings of the Early Supported Discharge consensus, 4 most respondents agreed that the length of the service should be adapted to patients’ needs and the availability of other community- based stroke services in the area. This flexible approach was seen by most respondents as a factor promoting the responsiveness of the service to patients’ needs and the local characteristics of healthcare provision.…”

Large-scale implementation of stroke early supported discharge: the WISE realist mixed-methods study

“…A total of 33 papers that met the inclusion criteria were identified for full-text review and 20 publications were included in the final evidence synthesis based on whether or not they could address the research aims. The papers were published between 2000 and 2017, with two studies conducted in Australia, 46,47 six in Sweden [48][49][50][51][52][53] and the rest in the UK. 13,19,23,38,39,[54][55][56][57][58][59][60] Ten studies focused on stroke ESD services, 13,19,23,38,46,47,49,50,54,58 four investigated community stroke rehabilitation services 39,57,59,60 and six examined stroke patients' transition from hospital to home.…”

“…The papers were published between 2000 and 2017, with two studies conducted in Australia, 46,47 six in Sweden [48][49][50][51][52][53] and the rest in the UK. 13,19,23,38,39,[54][55][56][57][58][59][60] Ten studies focused on stroke ESD services, 13,19,23,38,46,47,49,50,54,58 four investigated community stroke rehabilitation services 39,57,59,60 and six examined stroke patients' transition from hospital to home. 48,[51][52][53]55,56 Data collection methods mainly involved qualitative interviews; two studies conducted surveys, 46,56 two undertook observations, 19,59 two used consensus methods and one provided insights from a service development project.…”

Evaluating the implementation of an early supported discharge (ESD) program for stroke survivors: A mixed methods longitudinal case study

“…onward referral or liaison with other services reported by the previous study [6] were not identified here, possibly due to differences in the Outer Setting between nations. Previous Australian research expressed a similarly critical stance towards this service model [8,9], however…”

“…Two Australian studies also highlighted potential differences in perceptions between stakeholder groups. While patient perceptions were generally positive, staff were only moderately favourable as they doubted ESD could provide hospital equivalent therapy intensity [8,9].…”