Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: An observational cohort study

McCluskey, A; Ada, L; Kelly, PJ; Middleton, S; Goodall, S; Grimshaw, JM; Logan, P; Longworth, M; Karageorge, A

Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: An observational cohort study

McCluskey, A Ada, L Kelly, PJ Middleton, S Goodall, S

Grimshaw, JM Logan, P Longworth, M Karageorge, A

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Publication Type:: Journal Article
Citation:: BMC Health Services Research, 2015, 15 (1)
Issue Date:: 2015-07-29

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Field	Value	Language
dc.contributor.author	McCluskey, A	en_US
dc.contributor.author	Ada, L	en_US
dc.contributor.author	Kelly, PJ	en_US
dc.contributor.author	Middleton, S	en_US
dc.contributor.author	Goodall, S https://orcid.org/0000-0001-6611-6565	en_US
dc.contributor.author	Grimshaw, JM	en_US
dc.contributor.author	Logan, P	en_US
dc.contributor.author	Longworth, M	en_US
dc.contributor.author	Karageorge, A	en_US
dc.date.available	2015-07-14	en_US
dc.date.issued	2015-07-29	en_US
dc.identifier.citation	BMC Health Services Research, 2015, 15 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/36962
dc.description.abstract	© 2015 McCluskey et al. Background: Community participation is often restricted after stroke, due to reduced confidence and outdoor mobility. Australian clinical guidelines recommend that specific evidence-based interventions be delivered to target these restrictions, such as multiple escorted outdoor journeys. The aim of this study was to describe post-inpatient outdoor mobility and transport training delivered to stroke survivors in New South Wales, Australia and whether therapy differed according to type, sector or location of service provider. Methods: Using an observational retrospective cohort study design, 24 rehabilitation service providers were audited. Provider types included outpatient (n = 8), day therapy (n = 9), home-based rehabilitation (n = 5) and transitional aged care services (TAC, n = 2). Records of 15 stroke survivors who had received post-hospital rehabilitation were audited per service, for wait time, duration, amount of therapy and outdoor-related therapy. Results: A total of 311 records were audited. Median wait time for post-hospital therapy was 13 days (IQR, 5-35). Median duration of therapy was 68 days (IQR, 35-109), consisting of 11 sessions (IQR 4-19). Overall, a median of one session (IQR 0-3) was conducted outdoors per person. Outdoor-related therapy was similar across service providers, except that TAC delivered an average of 5.4 more outdoor-related sessions (95 % CI 4.4 to 6.4), and 3.5 more outings into public streets (95 % CI 2.8 to 4.3) per person, compared to outpatient services. Conclusion: The majority of service providers in the sample delivered little evidence-based outdoor mobility and travel training per stroke participant, as recommended in national stroke guidelines. Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12611000554965.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/632721
dc.relation.ispartof	BMC Health Services Research	en_US
dc.relation.isbasedon	10.1186/s12913-015-0952-7	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Occupational Therapy	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Inpatients	en_US
dc.subject.mesh	Survivors	en_US
dc.subject.mesh	Health Services	en_US
dc.subject.mesh	Guideline Adherence	en_US
dc.subject.mesh	Medical Audit	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Mobility Limitation	en_US
dc.subject.mesh	Stroke Rehabilitation	en_US
dc.subject.mesh	Translational Medical Research	en_US
dc.title	Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: An observational cohort study	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	15	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	0807 Library and Information Studies	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access
dcterms.license	This work is distributed under a Creative Commons Attribution license (CC BY) http://creativecommons.org/licenses/by/4.0
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	15	en_US

Abstract:

© 2015 McCluskey et al. Background: Community participation is often restricted after stroke, due to reduced confidence and outdoor mobility. Australian clinical guidelines recommend that specific evidence-based interventions be delivered to target these restrictions, such as multiple escorted outdoor journeys. The aim of this study was to describe post-inpatient outdoor mobility and transport training delivered to stroke survivors in New South Wales, Australia and whether therapy differed according to type, sector or location of service provider. Methods: Using an observational retrospective cohort study design, 24 rehabilitation service providers were audited. Provider types included outpatient (n = 8), day therapy (n = 9), home-based rehabilitation (n = 5) and transitional aged care services (TAC, n = 2). Records of 15 stroke survivors who had received post-hospital rehabilitation were audited per service, for wait time, duration, amount of therapy and outdoor-related therapy. Results: A total of 311 records were audited. Median wait time for post-hospital therapy was 13 days (IQR, 5-35). Median duration of therapy was 68 days (IQR, 35-109), consisting of 11 sessions (IQR 4-19). Overall, a median of one session (IQR 0-3) was conducted outdoors per person. Outdoor-related therapy was similar across service providers, except that TAC delivered an average of 5.4 more outdoor-related sessions (95 % CI 4.4 to 6.4), and 3.5 more outings into public streets (95 % CI 2.8 to 4.3) per person, compared to outpatient services. Conclusion: The majority of service providers in the sample delivered little evidence-based outdoor mobility and travel training per stroke participant, as recommended in national stroke guidelines. Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12611000554965.

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http://hdl.handle.net/10453/36962