Abstract TP354: Advancing Stroke Rehabilitation Programs Through Focused Quality Improvement Efforts

Introduction: Iowa inpatient rehabilitation facilities, skilled nursing facilities, and critical access hospitals participated in the American Heart Association’s (AHA) Mission: Lifeline Stroke Post-Acute Care (PAC) Initiative. This quality improvement (QI) initiative focused on enhancing stroke rehabilitation through evidence-based practice from 2022 through 2025. 45 facilities worked to enhance six areas: program management, staff and patient education, care coordination, medical management, and ongoing quality improvement. Methods: Participating facilities collaborated to improve patient care by identifying gaps in current practices, reviewing current literature, and model sharing between facilities. Facilities were provided one-on-one quality improvement support, educational materials for patients and staff, and resources and templates for enhancing policies and protocols. The AHA Post-Acute Care Stroke Program Standards guided facilities to assess and enhance specific areas of their programs. Participants reported improvement via pre-and post- implementation surveys. Results: Facilities with interprofessional committees to lead PAC stroke efforts increased from 62% to 100% of facilities. Survey results showed facilities who had a stroke specific education policy for staff increased from 38% to 100%. Additionally, staff education was enhanced with 77% of facilities expanding their education to include common deficits after stroke, risk factors for stroke reoccurrence, and review of an escalation of care policy. Facilities performing post-discharge phone calls within 3 business days increased from 46% to 85%. The availability of physicians and advanced practice providers within facilities did not improve and continues to be reported as a challenge by participants. 73% of facilities reported quarterly data over the course of the initiative. Conclusion: The Iowa Mission: Lifeline Stroke PAC initiative demonstrated increased adoption of evidence-based practices related to program management, staff and patient education, care coordination, and QI. This post-acute initiative demonstrates the positive effects of a program specific quality improvement initiative. Further evaluation needs to be done to assess the sustainability of these changes after the completion of the initiative.