Does an integrated care pathway improve processes of care in stroke rehabilitation? A randomized controlled trial.
OBJECTIVE
to evaluate whether integrated care pathways improve the processes of care in stroke rehabilitation.


METHODS
comparison of processes of care data collected in a randomized controlled trial.


METHODS
acute stroke patients undergoing rehabilitation randomized to receive integrated care pathways management (n=76) or conventional multidisciplinary care (n=76).


METHODS
proportion of patients meeting recommended standards for processes of care using a validated stroke audit tool.


RESULTS
integrated care pathways methodology was associated with higher frequency of stroke specific assessments, notably testing for inattention (84% versus 60%; P=0.015) and nutritional assessment (74% versus 22%, P<0.001). Documentation of provision of certain information to patients/carers (89% versus 70%; P=0.024) and early discharge notification to general practitioners (80% versus 45%; P<0.001) were also more common in this group. There were no significant differences in the processes of interdisciplinary co-ordination and patient management between the integrated care pathways group and the control group.


CONCLUSIONS
integrated care pathways may improve assessment and communication, even in specialist stroke settings.
Sulch
David
D
Department of Adult Medicine, Queen Elizabeth Hospital, Stadium Road, Woolwich, London SE18 4QH, UK. dsulch@doctors.org.uk
Evans
Andrew
A
Melbourn
Anne
A
Kalra
Lalit
L
D000368:Aged; D019033:Delivery of Health Care, Integrated / Q000379:methods; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome