The 2016 Rehabilitation Services Report - survivors and their families are being left to languish

Stroke survivors and their families are being left to languish, ill-informed and alone due to a rehabilitation health care system that doesn’t support their ongoing needs, according to a new Stroke Foundation national report released today.

The 2016 Rehabilitation Services Report, launched in Sydney, revealed that despite significant advancements in the treatment and care for stroke, patients were continuing to be denied best practice care in Australia. Stroke Foundation Chief Executive Officer Sharon McGowan said in four years Australia’s rehabilitation stroke care system had made little to no improvement, and in some areas had even gone backwards.

“It is inexcusable that services are not meeting the essential care elements and ignoring best practice guidelines,’’ Ms McGowan said.

“There is enormous variability in care and narrowing the gap between the best and worst hospitals must be a priority.

“Australia has some of the best and brightest health professionals working in stroke rehabilitation but a lack of appropriate hospital systems and processes continues to hinder best practice.

“This is compromising patient outcomes, leading to unnecessary suffering and adding increasing cost to the health system.

“Stroke survivors deserve the opportunity to make their best recovery possible, we can and must do better to assist them in achieving their recovery goals,” she said.

Stroke Foundation Clinical Council Member, health services researcher and occupational therapist Dr Annie McCluskey said Audit results highlighted the emotional and psychological needs of patients continued to be neglected.

“It is well recognised that mental and emotional wellbeing can significantly impact a patient’s rehabilitation and ultimately their quality of life, yet there has been no improvement in this area since the audit began (2008),’’ Dr McCluskey said.

“Too many patients are not getting an assessment for these common complications, and patients who have been identified as needing support or treatment are not being provided with the necessary care.

“Even more alarmingly, patients are not being prepared for the often long and challenging recovery journey which continues after hospital discharge. Half of patients are discharged without information about the cause of their stroke, let alone lifestyle advice and medication essential to preventing further strokes.”

Dr McCluskey added it was important to note there had been improvements in some areas and locations. “The practice of goal setting with patients increasing from 79 percent in 2010 to 89 percent in 2016 indicates with focused effort, investment and education improvements can be made,’’ she said.

“Pockets of high quality rehabilitation show it can be done and I commend those teams who have demonstrated consistent improvement in performance since the audit began in 2008.”

Ms McGowan echoed Dr McCluskey’s comments saying there was significant opportunity for improvements across the country but government leadership was required in order to reduce the disability caused by stroke.

“We know what good care looks like but sadly too few patients were experiencing it, she said. “If we can encourage the spread of service successes and share the learnings from their improvement journeys, future stroke patients, their families and carers will be beneficiaries.’’

In response to the Audit, the Stroke Foundation is calling on Federal and State Government to invest in resources to ensure the quality and consistency of stroke treatment and care across Australia.
This includes investing in the dedicated online web resource InformMe to ensure greater access to, and use of, stroke clinical guidelines. The Stroke Foundation is also encouraging coordinated state-wide quality improvement initiatives as well as local site activity to reduce variability in standards and address known gaps in care quality.

Key findings of the Audit included:
• Not one service reported meeting all 10 essential elements outlined in the National Stroke Rehabilitation Services Framework 2013.
• One-in-10 services offered a dedicated stroke rehabilitation unit. • 44 percent of services reported they did not routinely use the recommendations in the best practice guidelines to inform clinical care.
• 53 percent of patients were assessed for mental wellbeing, and of those identified as having a mental health issue two-out-of-three patients were not provided with any further psychological assessment or the necessary care.
• One-in-five patients were discharged without a plan to continue their ongoing care.
• One-in-five patients discharged without receiving recommended blood pressure or cholesterol lowering medications essential to stroke prevention.

About the audit. The National Stroke Audit Rehabilitation Services Report 2016 provides the most comprehensive snapshot to date of inpatient rehabilitation services for stroke in Australia.

The results are presented according to best practice guidelines in the National Rehabilitation Stroke Services Framework 2013 and the Clinical Guidelines for Stroke Management 2010.

In addition the Audit highlights progress that has been made over time. Click here for more.