The Stroke Specialty Programme at the National Rehabilitation Hospital, in collaboration with the patients, their families and carers, provides specialist stroke rehabilitation designed to lessen the impact of impairment and to assist people with stroke, to achieve optimum functional independence, social participation and community integration.
The Programme provides the national, and only, post-acute complex specialist inpatient rehabilitation service for people with stroke in the Republic of Ireland. Referrals are received nationwide from acute hospitals, HSE service areas and primary care.
The Stroke Specialty Programme is accredited by CARF (the Commission on the Accreditation of Rehabilitation Facilities) for inpatient, outpatient and home and community-based services.
Demographics, Activity and Outcomes for Inpatient Services – 2019
In 2019, 87 patients received inpatient rehabilitation services at the NRH. Of the patients discharged from the programme, 86 were admitted to the Comprehensive Integrated Inpatient Rehabilitation Programme (CIIRP), and 1 patient was admitted for short review or assessment.
DEMOGRAPHICS AND ACTIVITY
Of the 86 patients admitted to the Comprehensive Integrated Inpatient Rehabilitation Programme (CIIRP):
50 – (58%) had a diagnosis of Haemorrhagic Stroke
29 – (34%) had a diagnosis of Ischaemic Stroke
7 – (8%) had a diagnosis of Other Stroke
The programme continues to deliver high quality, effective rehabilitation in a national context of increasing patient complexity and numbers, increasing demand for earlier access, and a higher proportion of all patients having higher complexity of needs than previously seen. Our interdisciplinary teams of experts continue to deliver consistent and excellent patient outcomes with reduction in resources.
Programme Goals and Achievements in 2019
NRH has always served patients with stroke under the Brain Injury Programme achieving CARF Specialty Stroke Accreditation initially in 2010. With advances in the performance management system for the organisation in 2018 and 2019, the Stroke Specialty Programme was established separate to the Brain Injury Programme.
Person-centred coordinated care
Stratifying Stroke as distinct from other acquired brain injury and illness has enabled the programme to view, analyse and report data in a more person-centred coordinated way. New targets have been set for operational and functional outcomes and we have the country’s only specialist inpatient stroke rehabilitation facility
Enabling integrated care
Stroke is a leading cause of death and disability worldwide and in Ireland, approximately 10,000 people will have a stroke event each year. According to the recently published Irish Heart Foundation National Stroke Audit just one in four patients were recorded as having received acute or post-acute rehabilitation Increasing demands on healthcare services has led the Health Service Executive (HSE) in Ireland to consider the role of the patients in managing their own healthcare, with an emphasis on chronic disease self-management programmes and the development of a national framework for supported self-management.
These initiatives have guided the development and design of the NRH Stroke Specialty Programme and aim to make better use of consultations with professionals and for patients to take a greater role in managing their own health condition.
Dr Valerie Twomey (Senior Clinical Neuropsychologist) is the Programme Manager for the Stroke Specialty Programme (and also the Brain Injury Programme).
Patient care and treatment is delivered by Consultant led interdisciplinary (medical, nursing, health and social care) teams. Clinical responsibility is held by Professor Mark Delargy (Clinical Director, and Medical Director of the Brain Injury Programme) and Dr Jacinta Morgan (Medical Director of the Brain Injury Programme), with Consultant Colleagues Dr Jacinta McElligott, Dr Aaisha Khan, Dr Paul Carroll, Dr Jacqui Stow and Dr Kinley Roberts. Dr Eugene Wallace, Dr Raymond Carson and Dr John McFarlane provide rehabilitation input on behalf of NRH in major referring hospitals in Dublin and Cork respectively. A rotating team of NCHDs continue to provide medical support at the NRH.