Publications by authors named "Sulch D"
Background And Purpose: Integrated care pathways (ICP) may not reduce disability, institutionalization, or duration of hospitalization compared with conventional multidisciplinary team (MDT) care in organized stroke rehabilitation. Their potential to improve patient heath status or satisfaction with care is not known.
Methods: A comparison of quality of life, caregiver strain, and patient/caregiver satisfaction at 6 months after stroke was undertaken in 152 stroke patients randomized to receive ICP or MDT care.
Objective: to evaluate whether integrated care pathways improve the processes of care in stroke rehabilitation.
Design: comparison of processes of care data collected in a randomized controlled trial.
Participants: acute stroke patients undergoing rehabilitation randomized to receive integrated care pathways management (n=76) or conventional multidisciplinary care (n=76).
Background: an organized, goal-defined and time-specified plan of management as envisaged by the integrated care pathway approach can achieve quality outcomes at lower cost. Integrated care pathways may have applications to stroke management because diagnosis is well defined, complex interdisciplinary inputs are required and there is good evidence on best practice.
Method: we reviewed medical, nursing, rehabilitation and health services databases to identify studies on integrated care pathways in stroke management.
Background And Purpose: Integrated Care Pathway (ICP) is an organized, goal-defined, and time-managed plan that has the potential of facilitating timely interdisciplinary coordination, improving discharge planning, and reducing length of hospital stay.
Methods: An ICP for stroke rehabilitation based on evidence of best practice, professional standards, and existing infrastructure was developed. Its effectiveness was tested in 152 stroke patients undergoing rehabilitation who were randomized to receive ICP care coordinated by an experienced nurse (n=76) or conventional multidisciplinary care (n=76).
Background: Large intervention studies suggest that aspirin may reduce mortality when given to patients who present with strokes or transient ischemic attacks. We sought to determine whether patients who were already using aspirin at the time of an ischemic stroke had a lower mortality than those who were not.
Methods: A prospective cohort study was undertaken in patients (mean age 76 +/- 15 years) with acute ischemic stroke.
Background And Purpose: We studied the relationship between wheelchair propulsion and final walking ability in hemiplegic stroke patients who were unable to walk independently 3 or more weeks after stroke.
Methods: Sixty hemiplegic stroke patients unable to walk independently 3 weeks or more after stroke were entered in a study comparing independent walking and wheelchair propulsion. Eight patients were lost to follow-up.
A survey of three London hospitals found that approximately 0.45 patients per thousand new attenders die in the accident and emergency department and that there is evidence of poor management in about 10% of these deaths. The commonest faults were excessive delay before starting appropriate treatment and neglect of the basic principles of emergency medicine.
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