Background: The burden of stroke is increasing, but resources to provide care are limited. Redesigning healthcare systems can better support clinicians in providing high quality care to people with stroke. Transdisciplinary approaches can streamline work processes by embracing overlapping clinical skills and integrating roles to better use clinician time, skills, and knowledge.
Aims: The aim of this study was to evaluate the effectiveness of implementing a new co-designed transdisciplinary stroke assessment program (assessment tool and clinical protocol) to improve the quality of acute stroke care provided by allied health clinicians, measured by compliance to the national stroke guidelines and patient reported outcomes.
Methods: The single site pre-/post- observational study was carried out in an acute stroke unit over 22-months from February 2021. Data from retrospective chart audits were merged with patient reported outcome quality-of-life data (EQ-5D-3L) available from the Australian Stroke Clinical Registry (AuSCR) 90-180 days after admission. Descriptive analyses are presented.
Results: Data were collected for 179 participants with stroke (pre-phase N=63). Participants were similar in gender (males: pre-phase 46%, post-phase 53%) and age (pre-phase 64±16.38 years, post-phase 67±17.29 years). When the transdisciplinary assessment was used, 98% patients were assessed within 48 hours of admission (mean 23.66±8.77 hours), patients commenced rehabilitation sooner (mean 43.32±16.76 hours), and a communication screening tool was completed with 25% more patients. Episodes of adverse events such as patients falls did not increase, and quality-of-life on the EQ-5D-3L health utility scores were similar (pre-phase N=39, 0.79; post-phase N=69, 0.83). The transdisciplinary stroke assessment and associated improvements have been sustained for 19-months to date.
Conclusion: Implementing the transdisciplinary assessment improved compliance of allied health professionals with national stroke guidelines. Clinicians streamlined work processes and were better able to provide high quality stroke care. Next steps are to evaluate the transdisciplinary stroke assessment at other sites.