Grant: Project Grant

In 2014-2015, in Quebec, more than one hospitalization per hour was due to stroke. The annual costs of stroke for the Canadian economy is about 2.7 billion dollars in medical services, hospitalization costs, salary loss, and productivity loss. Enhancing stroke care delivery can reduce these costs, while optimizing patient outcomes. Strong evidence exists on the need to begin rehabilitation as soon as the patient's medical status has stabilized. This strategy of early supported discharge (ESD) has been shown to be both more effective and more efficient than standard care. However, ineffective collaboration among services provided during patients' rehabilitation and community reintegration, the failure to consider the patient and family members as partners, as well as a lack of standardisation to ensure best communication practices throughout the care continuum are important contextual barriers to country-wide implementation of ESD. Based on current international stroke care best practices and recent developments in telecommunication technologies to provide long-distance rehabilitative services, we developed an innovative intervention to provide rehabilitation treatments through remote, live consultations with an interdisciplinary group of clinicians. Medical information will be made accessible via telecommunication technologies to all professionals involved in the rehabilitation process, including the patients' primary care providers. This study will evaluate the effectiveness and the implementation of this intervention, while providing strategies to improve interorganizational collaboration and services integration. Our team is composed of researchers, practitioners and decision-makers. A panel of Canadian health system decision makers will enhance the proposed intervention, relate the relevance and anticipated use of the findings within their province, and foster adaptation of improved stroke care elsewhere.