Background: Stroke education (SE) is an important quality measure that has been shown to be inconsistently provided and ineffectively delivered. In response we have developed a pharmacist driven stroke education program (SEP) for patients admitted with stroke/TIA. Here, we describe the development, implementation, and encounters from this initiative.
Methods: A stroke service team (SST) consisting of a board-certified cerebrovascular physician, cerebrovascular fellows, and a clinical pharmacist specialist (CPS) was established at the VA Greater Los Angeles Healthcare System. The CPS is alerted when any stroke/TIA patients are admitted and follows the patient until time of transfer/discharge. At that time, most diagnostic studies are complete and a likely stroke etiology has been determined, allowing for the development of a patient centered comprehensive stroke care and prevention plan based on individualized stroke risk factor analyses with input from interdisciplinary fields including the SST, rehabilitation specialists, and speech therapists. SE is provided at the time of discharge and addresses risk factors for stroke, stroke warning signs, activation of emergency medical services, need for follow-up after discharge and medications prescribed. The CPS also reviews stroke location, nature and quality of the stroke, and relays the initial patient centered comprehensive care plan to the patient in patient-level language. Visual aids assist in educating patients and a personalized education sheet is provided. The CPS is also responsible for documentation of SE for future evaluation of process measures.
Results: Consistent implementation of the pharmacist driven comprehensive stroke education program (SEP) began in July 2013. To date, there have been 172 SE encounters documented. Quality improvement audits indicate close to 100% of all patients admitted for stroke receive SE.
Conclusions: Here we show the successful implementation of a pharmacist driven comprehensive SEP designed to improve patient satisfaction/knowledge and improve hospital adherence to stroke quality measures. As pharmacists are trained to communicate with medical personnel and patients, they may be the ideal candidate to provide comprehensive and quality SE.