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New Management System for Stroke Patients Cuts Hospital Bed Usage by More Than 25%

Care team makes twice-weekly rounds

A new approach to the management of acute stroke has reduced the number of stroke-patient bed days by more than 25% at a hospital in British Columbia, Canada, according to a study of the system presented at the annual Canadian Stroke Congress in Vancouver.

In total, it was estimated that the new system is saving the 380-bed hospital more than 1,000 bed-days per year. This represents annual savings of up to C$800,000 — achieved without the need for new investments in devices, treatments, or personnel.

The program is called Proprietary Physician, or Pro-MD. It involves assuring that one of the hospital’s five neurologists is always designated as primarily responsible for best bed usage and patient flow in the acute-stroke unit.

A crucial component of the program is that beyond the normal care to the patients by their own neurologists and other caregivers, the Pro-MD program involves twice-weekly rounds of all patients with the complete care team. This includes the ward’s head nurse, a physiotherapist, an occupational therapist, a social worker, a transition nurse, a pharmacist, the rehabilitation ward’s head nurse, and the patient’s family.

The meetings take only 30 to 45 minutes to discuss the usual half-dozen patients but result in everyone agreeing on the course of care, including the family. This is crucial, particularly when discussing the timing and terms of a patient’s discharge from hospital, said author Dr. John B. Falconer.

The program could be used in other areas of the hospital but is particularly relevant to stroke care because of the many players involved and the crucial role the patient and family play in rehabilitation, Falconer remarked.

Source: EurekAlert; October 6, 2014.

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