Abstract WMP119: Evaluating Discharge Patterns in the Stroke Population


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Abstract

Hypothesis: Determining discharge patterns in the stroke population will assist in directing appropriate resources and patient outcomes.Methods: A retrospective review of 917 records was completed at a Joint Commission Certified Primary Stroke Center. Only patients with a confirmed diagnosis of stroke were included. Discharge destination was evaluated as well as NIHSS scores (which were then averaged) and stroke subtype. An assessment of rationale for patients not receiving Activase was also completed.Results: The following table illustrates the results of this review.This subset was further evaluated for non-treatment rationale; 80% arrived outside a treatment window; 13% were mild or rapidly improving; 5% had documented contraindications; the remaining 2% were a combination of patient refusal and missed opportunities. Interestingly, all missed opportunities resulted in discharge to SNF or AR. It appears, based on these data, clinical decisions made to withhold Activase in the setting of rapidly resolving symptoms did not result in further in-patient care in the majority of patients.Conclusions: Based on these data, nearly half of all strokes are discharged back into the community; an evaluation of available community and outpatient services may be beneficial. Further evaluation of potential barriers and opportunities to expand access to acute rehabilitation may be warranted. An evaluation of patients discharged to SNF may also be valuable to ensure discharge to most appropriate level of care to ensure best outcomes

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