Stroke Unit at Home: A Prospective Observational Implementation Study for Early Supported Discharge from the Hospital

It has been well established that the stroke patient’s needs are best met in an organized stroke unit [3].Stroke unit care is effective in reducing death and disability, as well as improvingpost-stroke outcomes [3]. Furthermore, an alternative service has been reported where stroke patients in hospitals are offered early supported discharge (ESD) with rehabilitation at home [4,5]. The ESD is conducted by multidisciplinary team members with experience in stroke rehabilitation and the ESD service could either have a community or a hospital base [4]. When appropriately resourced and provided for a selected group of stroke patients with mild to moderate severity,ESD can reduce the length of hospital stay[4,5]. In addition, a benefit to functional outcome has been reportedto reduce long-term dependency and admission to institutional care, with no apparent adverse impact on the mood or subjective health status of patients or carers [4-7]. However, the content of ESD for stroke patients is highly variable among different stroke organizations [4]. The ESD service thus needs to be locally adapted in order to enable appropriate implementation [8].