Rehabilitation Time Limited!

An audit of services for stroke patients by the Health Service Executive has found that 73% of hospitals are unable to provide adequate levels of rehabilitation therapy to those who need it.

The audit, which was conducted in conjunction with the Irish Heart Foundation, shows major nursing, medical and therapy staff deficits in stroke rehabilitation centres.
The incidence of stroke is rising by about 350 cases every year – a rise attributed to the ageing population.
This audit of 26 out of 29 rehabilitation units was carried out to examine the adequacy of services for patients after their initial period of treatment.
It found major deficiencies in vital recovery services for stroke patients, including a lack of nursing staff, medical professionals and psychologists.
It also found that 73% of hospitals were unable to provide recommended levels of therapy.
The HSE's clinical lead for stroke, Professor Joe Harbison, said the health service would probably need around 250 extra therapists for the adequate treatment of stroke.
Almost two thirds of facilities surveyed did not have a stroke specialist.
The vast majority of the hospitals also had no access to community rehab teams to continue essential therapy for patients after they are discharged home.
The audit team recommends a major investment to provide more beds, healthcare professionals, therapists and community teams to deal with the deficiencies highlighted.



Prof. Harbison said a person's chance of recovering from stroke is "dependent on the skills of the people" who are in the hospital where they being treated.
Speaking on RTÉ’s Morning Ireland, he said this may "depend a little bit on geography, on where your access to specialist rehabilitation services are".
He said these services can also be dependent on age as "a lot of the rehabilitation services in Ireland are run through elderly care services".
In the case of 50% of the units, if "you're under 50, you can't get into the unit" and he said these people are "often left waiting maybe months to get into the National Rehabilitation hospital".
Prof. Harbison said when people have had their initial treatment for stroke, they are moved onto a rehabilitation centre but that's "very often non specific for stroke".
He said there may be certain skills lacking in this centre - while they may get physiotherapy and occupational therapy, they may not get specialist therapy and are unlikely to get the duration of the therapy they need.
He added that they may not get other therapies such as psychology at all, as only one third of the hospitals have any access to psychology services.
Claiming that access to rehabilitation services and sufficient rehabilitation staff is a long-standing problem, Prof. Harbison said rehabilitation should happen in the
first 24 hours of stroke.

Rugby Rehab Research!

A study of 200 schoolboy rugby players from five Dublin schools hopes to establish more information on the treatment and rehabilitation of concussion.

The €700,000 pilot study, launched today by the Sports Surgery Clinic, aims to collect data from brain testing before and after a concussion.
The five schools involved are Blackrock College, St Michael's College, St Andrew's College, Gonzaga College and St Mary's College.
Students taking part in the study will under go a pre-season brain screening. In the event they do sustain a concussion while playing rugby, they will be subject to a 'concussion passport screening'.
This involves a range of tests including balance, cognitive skills, eye movement, ocular motor
movement and oxygen consumption while on a treadmill.

 

As well as better understanding the affect and treatment of concussion, the screening hopes to eliminate unnecessary tests from concussion rehabilitation.
It also hopes to create a continuity of medical information for those being treated, as the subjects of the study can bring the body of test results with them to their GPs or other medical practitioners.
The Director of Rehabilitation and Research at the Sports Surgery Clinic has said the results of the tests will form a baseline measurement for those treating concussion.
Speaking on RTÉ's Morning Ireland Dr Andy Franklyn-Miller said this will allow them to improve the care provided to those who have sustained concussion.

Report suggests stroke patients could benefit from earlier hospital release

Stroke survivors could benefit from better rehabilitation in the community rather than longer stays in hospital, according to a report by the ESRI and the Royal College of Surgeons of Ireland.

The report, funded by the Irish Heart Foundation, finds that 54% of stroke survivors could be discharged from hospital earlier each year. 

The move to care in the community would free up acute hospital beds and save up to €7m in health expenditure.

The authors of the report say more than 3,000 patients would benefit each year from community rehabilitation, reducing hospital bed days by 24,000.

It would require a substantial increase in the resourcing of community nurses and community therapists, and according to the report, this could be funded from savings in the reduced cost of bed days. 

The Report published today:Towards Earlier Discharge, Better Outcomes, Lower Cost: Stroke Rehabilitation in Ireland

View press release here