A Telephone Intervention for Ischemic Stroke Patients to Support Transitions of Care

Abstract

Stroke mortality has moved from the second leading cause of death in 2013 to the fifth leading cause of death in 2016 as a result of stroke certified hospitals, standards of care, enhanced tracking and control of risk factors, and improvements in the hospital systems. Stroke patients are most vulnerable during the transition from hospital to home. Leading to an unsuccessful recovery and/or recurrent stroke, with 53% of these being preventable (Renke & Ranji, 2015). Transition of care programs have shown successful results in decreasing 30-day readmissions, higher patient satisfaction, and decreased adverse events (Hirschman, Shaid, McCauley, Pauly, & Naylor, 2015). This project proposal will evaluate the effectiveness of a 30-day post discharge telephone intervention for stroke survivors and/or their caregivers. This will be accomplished by determining stroke knowledge, survivor functional status, and readmission rates. The information gained in this study will provide the site with potential areas to improve patient care and experience and facilitate a future TOC program.