Post-discharge telephone follow-up among ischemic stroke survivors at a comprehensive stroke center in the southeastern United States: a best practice implementation project.

INTRODUCTION

Stroke remains a leading cause of death and disability, with high readmission rates following discharge. Improving post-discharge stroke care can enhance risk factor control, community reintegration, and self-management.

OBJECTIVES

This project aimed to improve telephone follow-up (TFU) for acute ischemic stroke and transient ischemic attack survivors at a comprehensive stroke center in Mississippi, USA.

METHODS

Guided by the JBI Evidence Implementation Framework, the project used clinical audits to assess barriers and enablers of compliance with evidence-based practices (EBPs). Two such practices were used as audit criteria. A baseline audit was conducted, barriers to EBPs were identified, and strategies to address the barriers were planned and implemented. Follow-up audits were conducted, using the same two audit criteria and methods, with the results compared to baseline.

RESULTS

The baseline audit (n = 30) revealed low compliance with both EBPs (0% and 40%). An unclear and outdated TFU protocol for stroke patients was identified as the primary barrier to achieving EBPs. The improvement strategy focused on three key initiatives: (i) creating a standardized, multidisciplinary discharge TFU process; (ii) creating and implementing a post-discharge TFU template in the electronic health record; and (iii) providing staff education on the new process and documentation. The post-intervention audit (n = 30) showed statistically significant improvements (100% for both criteria; p < 0.001).

CONCLUSION

Implementing a structured TFU protocol significantly improved post-discharge follow-up for stroke survivors. Future efforts should focus on sustaining these improvements and evaluating their long-term impact.

SPANISH ABSTRACT: http://links.lww.com/IJEBH/A449.