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Improving Stroke Patients’ Post-Hospital Care Transitions

The Ohio Department of Health was one of three state health departments in the nation that received CDC Coverdell funding from 2012-2015 to improve the quality of stroke patients’ “transitions of care” (TOC) from in-hospital to post-hospital care settings. ODH asked hospitals participating in the Coverdell Stroke Program to schedule and document, prior to discharge, appointments with primary care and neurology providers, to improve patients’ care transitions. The projects ODH implemented with participating hospitals are an important step in improving the quality of stroke patients’ care transitions from the hospital to community care. Ohio Coverdell hospitals are commended for their commitment to improving stroke patients’ care transitions and congratulated for their success, and this work continues today.

Outcomes & Findings:

• More than 90% performance improvement in scheduling follow-up appointments for stroke patients prior to hospital discharge by Coverdell hospitals, April 2013-March 2014 (2015 Poster).
• Demonstration that a higher portion of patients with a weekday discharge had a follow-up appointment with primary care or specialty care, compared to patients with a weekend discharge (2015 Presentation).
• More than 85% performance improvement in scheduling and documenting neurological follow-up appointments for stroke patients prior to discharge home by four Coverdell hospitals (2014 Abstract).
• In 2015, 24% of stroke patients discharged from a Coverdell hospital to home had a primary care appointment scheduled and documented by hospital staff prior to discharge, and 32% of stroke patients discharged from a Coverdell hospital to home had a neurology appointment scheduled prior to discharge.

 

Last Reviewed: 11/15/2016