Do integrated stroke units affect patient and family experience of care transitions?

Abstract

Patients and families identify discharge from hospital as highly challenging. Less is known about experiences of transition between acute services and inpatient rehabilitation. We aimed to understand the experiences of patients and families as they transition to inpatient rehabilitation services, before and after the opening of a new integrated stroke and rehabilitation unit (ISU). Adults were recruited 7 days after transfer to inpatient rehabilitation, in two 6-month periods before and after the opening of the ISU. Their experiences of care continuity were evaluated with a survey. Univariate analyses compared survey data pre- and post-ISU. A subset of participants completed semi-structured interviews that underwent thematic analysis. 150 patients were recruited (median age 60 years, range 20-92 years, 72 female). There were no differences between pre- and post-ISU survey scores for patient or family experiences (all <i>p</i> > 0.3). Interview analysis identified 3 major themes: "Whānaungatanga - the foundation of patient experience", "In the dark and out of control", and "A nice view…but I want to be able to do more." Implementation of an integrated stroke and rehabilitation unit maintained levels of patient and family satisfaction. Interviews identified important themes for services planning to improve patient experience.