ArticleBMC health services research2014
A qualitative exploration of discharge destination as an outcome or a driver of acute stroke care.
Article in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- What factors affect clinical decision-making about access to stroke rehabilitation? A systematic review.Clinical rehabilitation · 2019Pooled it
- Coproducing an intervention to support stroke unit staff to provide information about recovery to patients and carers.PEC innovation · 2026Article
- Predictive Validity of Motor Assessment Scale on Poststroke Discharge Destination.Rehabilitation research and practice · 2024Article
- From Admission to Discharge: Predicting National Institutes of Health Stroke Scale Progression in Stroke Patients Using Biomarkers and Explainable Machine Learning.Journal of personalized medicine · 2023Article
- Evaluation of Blood Biomarkers and Parameters for the Prediction of Stroke Survivors' Functional Outcome upon Discharge Utilizing Explainable Machine Learning.Diagnostics (Basel, Switzerland) · 2023Article
- Pre-stroke disability and stroke severity as predictors of discharge destination from an acute stroke ward.Clinical medicine (London, England) · 2021Article
- Developing a Predictive Tool for Hospital Discharge Disposition of Patients Poststroke with 30-Day Readmission Validation.Stroke research and treatment · 2021Review
- Does pre-existing cognitive impairment impact on amount of stroke rehabilitation received? An observational cohort study.Clinical rehabilitation · 2019Observational
- The Effect of Frailty on Discharge Location for Medicare Beneficiaries After Acute Stroke.Archives of physical medicine and rehabilitation · 2019Article
- What influences decisions about ongoing stroke rehabilitation for patients with pre-existing dementia or cognitive impairment: a qualitative study?Clinical rehabilitation · 2018Article
- Hospital Discharge Disposition of Stroke Patients in Tennessee.Southern medical journal · 2017Article
- Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany patients with acute stroke do not receive recommended care in tertiary hospital settings. Allied health professionals have important roles within multidisciplinary stroke teams and influence the quality of care patients receive. Studies examining the role of allied health professionals in acute stroke management are scarce, and very little is known about the clinical decision making of these stroke clinicians. In this study we aimed to describe factors that influence the complex clinical decision making of these professionals as they prioritise acute stroke patients for recommended care. This qualitative study was part of a larger mixed methods study.
methodsThe qualitative methodology applied was a constructivist grounded theory approach.Fifteen allied health professionals working with acute stroke patients at three metropolitan tertiary care hospitals in South Australia were purposively sampled.Semi-structured interviews were conducted face to face using a question guide, and digital recording. Interviews were transcribed and analysed by two researchers using rigorous grounded theory processes.
resultsOur analysis highlighted 'predicted discharge destination' as a powerful driver of care decisions and clinical prioritisation for this professional group. We found that complex clinical decision making to predict discharge destination required professionals to concurrently consider patient's pre-stroke status, the nature and severity of their stroke, the course of their recovery and multiple factors from within the healthcare system. The consequences of these decisions had potentially profound consequences for patients and sometimes led to professionals experiencing considerable uncertainty and stress.
conclusionsOur qualitative enquiry provided new insights into the way allied health professionals make important clinical decisions for patients with acute stroke. This is the first known study to demonstrate that the subjective prediction of discharge destination made early in an acute admission by allied health professionals, has a powerful influence over the care and rehabilitation provided, and the ultimate outcomes for stroke patients.
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Registered trials
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