Ontario Stroke Evaluation Report 2018 - Implications for Occupational Therapists

Of the approximately 13,000 Ontarians who survive an acute care hospitalization for stroke or transient ischemic attack each year, about 1,100 are admitted to complex continuing care (CCC) and 1,300 to long-term care (LTC) within 180 days of discharge from acute care. To date, the care provided to stroke survivors in these settings has been largely unexamined.  The Ontario Stroke Evaluation Report 2018: Stroke Care and Outcomes in Complex Continuing Care and Long-Term Care, developed by CorHealth Ontario and the Institute for Clinicial Evaluative Sciences (ICES), aims to address this knowledge gap.

The report notes that stroke rehabilitation “improves independence, reduces hospitalization, saves lives and should be considered the standard of care for all stroke survivors.” Additionally, Canadian Stroke Best Practice Recommendations state that “survivors of moderate to severe stroke should be given an opportunity to participate in inpatient rehabilitation when ready and have assessments at regular intervals to determine access to inpatient or outpatient rehabilitation.” However, of the 1,085 stroke survivors admitted to CCC in 2014/15, the majority (n=636) transitioned directly to CCC from acute (i.e. did not receive inpatient rehabilitation). A similar result was found for those transitioning to LTC with 810 of 1,411 stroke survivors not receiving any inpatient rehabilitation prior to their transfer to LTC.

View summary infographic.

Implications for Occupational Therapists

The authors have developed a summary report for occupational therapists which lends interesting, if not disappointing, insights into the access stroke patients in CCC or LTC have to occupational therapy services.  This data and the reflective questions they pose to occupational therapists and the profession are worth reviewing.  The authors challenge occupational therapists to consider;

  • How can I change my practice to optimize interventions?
  • How can I advocate for change in these settings?
  • How can I work with the interprofessional team to leverage diverse expertise and the limited available resources?
  • How can the Ontario Society of Occupational Therapists leverage this report?

View Ontario Stroke Evaluation Report 2018:  Summary for Occupational Therapists

OSOT would value reactions and insights from members working in stroke rehabilitation, CCC and/or Long-Term Care Homes.  How can the Society assist you to leverage the information and data that this report presents when the value of occupational therapy services for stroke patients is well validated.  Please share your thoughts and interest.