Benefit of a Stroke Management Program

Abstract

Hospital participation in stroke bundle programs presents financial risk. There are limited comparative data on the success of such programs. The authors aimed to assess the success of a management program in reducing the number of patients admitted to a skilled nursing facility (SNF), average length of stay, and the number of patients discharged to inpatient rehabilitation units. Three program metrics included reduction in number of stroke patients admitted to SNF, reduction in length of stay at SNFs, and reduced 90-day hospital readmission rates. The program was implemented during a 3-year period from October 1, 2015, through September 30, 2018, included 803 patients in the data, and demonstrated financial gain with positive patient outcomes. There was a 0.5% reduction in the number of stroke patients admitted to SNF. Sending patients home with a high-quality home care agency for rehabilitation and navigation assistance were the goals for this metric. A 1.65-day reduction in length of stay for overall SNF providers was noted. This was achieved by utilizing a preferred network of skilled facilities and community partners that the nurse navigator interfaced with weekly. The proportion of patients discharged to inpatient rehabilitee units was 2.2% less than in the baseline years. With the implementation of a stroke nurse navigator, hospital readmissions as a percentage of admissions for stroke decreased by 4%. Overall return on investment was greater than 400% after accounting for additional staffing and data/license fees.