Enhanced Early Supported Discharge Project
Research type
Research Study
Full title
Evaluation of the implementation of an Enhanced Early Supported Discharge Service (EESD) for stroke survivors with moderate to severe impairments and the resulting clinical and cost outcomes when compared to similar patients in an unchanged stroke care pathway in a neighbouring borough.
IRAS ID
141232
Contact name
Charlie Davie
Contact email
Sponsor organisation
North Central London Research Consortium (Noclor)
Research summary
An Early Supported Discharge (ESD) service for stroke is an evidence based intervention that aims to enable a particular group of patients who have a mild to moderate stroke to be discharged from hospital early and receive the same intensity of rehabilitation in their home. Analysis of almost 1600 patients has demonstrated that ESD can reduce long term dependency, decrease admission to institutionalised care as well as shorten hospital stay. This model has also been shown to reduce death and institutionalised care at five years (Fjaetoft et al, 2011) and has been shown to be cost effective (Saka, 2005.) A study by NHS London showed that patient outcomes has not been affected by being treated at home and that there have not been an increase in re-admissions due to the setting up of an ESD service.
However, those with moderate to severe strokes are often not eligible for ESD rehabilitation.
This study aims to offer twenty Camden residents an Enhanced Early Supported Discharge service in which stroke survivors with moderate to severe impairments are eligible. Participants will be recruited from the University College London Hospital Hyper Acute Stroke Unit and acute stroke units at UCLH and the Royal Free Hospital.
This study will compare health and economic outcomes of early Multi-disciplinary stroke rehabilitation in the community compared to traditional inpatient and community Multi-disciplinary rehabilitation for people with moderate to severe post stroke impairments.
We will also collect the views of the participants and their carers regarding being treated at home.The objectives are to discover:
1. What impact does the implementation of an Enhanced ESD service for stroke survivors with moderate to severe impairments have on clinical and cost outcomes compared to an unchanged care pathway in a neighbouring borough?
2. What are the staff, participant and carer views and experiences of an Enhanced ESD service?REC name
London - Chelsea Research Ethics Committee
REC reference
13/LO/1848
Date of REC Opinion
30 Dec 2013
REC opinion
Favourable Opinion