title: A cross-sectional assessment of stroke rehabilitation in Nebraska hospitals.
abstract: OBJECTIVE
  To assess the structure and process of stroke rehabilitation in Nebraska hospitals.
  
  
  METHODS
  Cross-sectional mail survey using the Dillman tailored-design method of administration.
  
  
  METHODS
  Hospitals in Nebraska.
  
  
  METHODS
  Approximately 77% of the 84 Nebraska hospitals that provide stroke rehabilitation are critical access hospitals (CAHs) that are limited to 25 beds. Our study sample of hospitals (N=53) included the 19 hospitals licensed for 47 to 689 beds (non-CAHs) and a stratified random sample of 34 of the 65 CAHs.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Self-reported stroke rehabilitation team structure and processes, purposes of and barriers to the use of evidence-based standardized assessments, specific assessments used, and access to specialized stroke rehabilitation services and community resources.
  
  
  RESULTS
  Thirty-six (68%) of the 53 hospitals responded to the survey. Approximately 61% of the hospitals used an organized team to provide stroke rehabilitation; 8% of the hospitals-all non-CAHs-had a team dedicated to stroke rehabilitation. After adjusting for hospital size, having an organized team was significantly associated with the use of standardized assessments to improve communication, measure progress and outcomes, evaluate effectiveness of practice, and compare patient outcomes across conditions. Access to specialized stroke rehabilitation professionals and services was significantly greater in non-CAHs.
  
  
  CONCLUSIONS
  Hospital size and the presence of a team are determinants of the structure and process of stroke rehabilitation in Nebraska hospitals. Further research is needed to determine (1) whether team structure is a determinant of stroke rehabilitation outcomes across the continuum of care settings, (2) the needs of rural stroke survivors, and (3) whether technology can facilitate the use of stroke rehabilitation standardized assessments by rural health care professionals.
authors.affiliation: Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE 68198, USA. kjonesj@unmc.edu
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Jones
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Cochran
authors.forename: Lou E
authors.initials: LE
authors.lastname: Jensen
authors.forename: Tammy G
authors.initials: TG
authors.lastname: Roehrs
authors.forename: Kathleen G
authors.initials: KG
authors.lastname: Volkman
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Goldman
mesh_terms: D003142:Communication; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D009329:Nebraska; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D010814:Physical Therapy Department, Hospital / Q000458:organization & administration* / Q000592:standards; D026741:Physical Therapy Modalities / Q000458:organization & administration* / Q000592:standards; D020521:Stroke / Q000453:epidemiology; D000071939:Stroke Rehabilitation