Article: Sharon - Are Best Practice Guidelines Effective?

Sharon

The Canadian Stroke Network’s best practice guidelines and the research evidence base support the development of organized stroke rehabilitation units, especially combined acute/rehabilitation units. However, emerging evidence suggests that across Canada, the majority of stroke patients do not receive this type of service.

Despite the best practice recommendations for intensive therapy provided by rehabilitation therapists familiar with/trained in neurorehabilitation, the evidence suggests that many stroke patients spend very little time in therapy, that much of their day is spent alone or resting.

Indeed a recent study is surprised about:

1. How low the percentage of stroke patients admitted to specialized stroke rehabilitation units is,
2. How low the therapist to patient ratios are, and,
3. That treatment in specialized stroke rehabilitation units located in free-standing rehabilitation hospitals does not necessarily result in the benefits one might expect from specialized care.

They suggest that rather than focusing on rigid structural criteria and processes of care is not enough. Focusing on patient centred care and components of care that are in the patient’s best interest may be necessary.

This includes:

1. Making sure that, whenever possible, the same staff members are responsible for rehabilitating stroke patients will help them to develop stroke expertise. 
2. Making therapy intensity a focus day-to-day will ensure that rehabilitation staff spends more time directly with patients, which will further promote their stroke expertise.

You can read the full article:

• Meyer, M., et al., (2011). Organized Stroke Rehabilitation in Canada: Redefining Our Objectives. Topics in Stroke Rehabilitation.

Tell About Your Experience

• Some stroke survivors complain that the therapy is too intensive, that they need to rest. What was your experience?  
• How much time did the speech language, physiotherapist, and occupational therapist spend with you or your family member?  Was it enough? Were you too tired?