Article

OBJECTIVE: To assess the structure and process of stroke rehabilitation in
Nebraska hospitals. DESIGN: Cross-sectional mail survey using the Dillman
tailored-design method of administration. SETTING: Hospitals in Nebraska.
PARTICIPANTS: Approximately 77% of the 84 Nebraska hospitals that provide stroke
rehabilitation are critical access hospitals (CAHs) that are limited to 25 beds.
Our study sample of hospitals (N=53) included the 19 hospitals licensed for 47 to
689 beds (non-CAHs) and a stratified random sample of 34 of the 65 CAHs.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-reported stroke
rehabilitation team structure and processes, purposes of and barriers to the use
of evidence-based standardized assessments, specific assessments used, and access
to specialized stroke rehabilitation services and community resources. RESULTS:
Thirty-six (68%) of the 53 hospitals responded to the survey. Approximately 61%
of the hospitals used an organized team to provide stroke rehabilitation; 8% of
the hospitals-all non-CAHs-had a team dedicated to stroke rehabilitation. After
adjusting for hospital size, having an organized team was significantly
associated with the use of standardized assessments to improve communication,
measure progress and outcomes, evaluate effectiveness of practice, and compare
patient outcomes across conditions. Access to specialized stroke rehabilitation
professionals and services was significantly greater in non-CAHs. CONCLUSIONS:
Hospital size and the presence of a team are determinants of the structure and
process of stroke rehabilitation in Nebraska hospitals. Further research is
needed to determine (1) whether team structure is a determinant of stroke
rehabilitation outcomes across the continuum of care settings, (2) the needs of
rural stroke survivors, and (3) whether technology can facilitate the use of
stroke rehabilitation standardized assessments by rural health care
professionals.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS