Goal setting practice in services delivering community-based stroke rehabilitation: a United Kingdom (UK) wide survey

Figures & data

Table 1. Characteristics of services providing community-based stroke rehabilitation.

Service characteristic	Number^a	% of services
Service type	427
Community rehabilitation team^b	152	36
Early supported discharge team^c	51	12
Combined community rehabilitation and early supported discharge team	72	17
Bespoke team	50	11
Hospital-based outreach team	25	6
Reablement team^d	21	5
Other team type (including Intermediate care teams^e; specialist stroke nurse teams, community neurology teams, private teams, adult acquired speech and language therapy teams; stroke orthoptic team, domiciliary occupational therapy and physiotherapy teams)	56	13
Multidisciplinary or unidisciplinary	407
Multidisciplinary	335	82
Unidisciplinary	72	18
Health professionals represented in multidisciplinary services	407
Physiotherapy	348	85
Occupational Therapy	344	84
Rehabilitation Assistant	284	70
Speech and Language Therapy	259	64
Nurse	177	44
Dietitian	104	26
Psychologist	97	24
Social Worker	80	20
Doctor	78	19
Other health professionals (including case managers, mental health practitioners, podiatrists, social care workers, pharmacists & orthoptists)	91	22
Types of unidisciplinary services	72
Speech and language therapy service	25	35
Physiotherapy service	20	28
Occupational Therapy service	17	24
Other unidisciplinary service (including nurse, dietetic, orthoptic, psychology, podiatry)	10	13
Number of health professionals represented in service (full or part time and including  rehabilitation assistants)	400
2–4	79	20
5–17	237	59
18 or more	84	21
Diagnosis of patients seen	437
Mixed (stroke patients and other diagnostic groups)	312	71
Stroke patients only	125	29
Age range of patients seen	426
Under 65 years	57	13
Over 65 years	113	27
Below and above 65 years	256	60
Approximate duration of service input	390
0–4 weeks	16	4
5–12 weeks	206	53
13–21 weeks	104	27
22 weeks or more	64	16
Maximum sessions provided per week	391
1 session or less	5	1
2–5 sessions	277	71
More than 5 sessions	109	28
Where are patients usually seen?	433
Patient’s own home	361	83
Other location (Outpatient clinics or gyms, health centres, community centres, day hospitals and the workplace)	72	17

^aNumber of services that responded to each question.

^bCommunity Rehabilitation Team – typically multi-disciplinary teams working together to provide co-ordinated rehabilitation to people living in the community.

^cEarly Supported Discharge Team – services that offer selected stroke patients an early discharge from hospital with more rehabilitation at home [23].

^dReablement team – service designed to prevent hospital admission or post-hospital transfer to long–term care or to reduce the level of on-going home care support required [39].

^eIntermediate care team – layer of care (mainly targeted at older people) between primary care and specialist services to prevent unnecessary hospital admission, support early discharge and reduce the need for long-term residential care [40].

Table 2. Methods used to guide goal-setting practice.

Methods (based on responses from 315 services)	Number of services	Percentage of services
Goal Attainment Scaling	96	30%
Canadian Occupational Performance  measure	63	20%
Goal setting and action planning (G-AP)  framework	6	2%
Team members use own methods	140	44%
Team developed own method	92	29%
Other method used	49	16%

96 services (25%) reported use of two or more methods.

Table 3. Reported service priority levels.

	Respondents reports of service priority levels % (n)
Priority area (number of respondents)	Low	Moderate	High	Don’t know
Setting rehabilitation  goals (372)	2% (7)	13% (47)	84% (314)	1% (4)
Involving patients (369)	1% (3)	9% (33)	89% (330)	1% (3)
Involving carers (363)	5% (17)	40% (145)	54% (195)	1% (5)
Involving patients with  cognitive/communication  difficulties (372)	2% (7)	15% (56)	81% (299)	1% (5)

Figure 1. Reported routine use of specific goal-related activities.

Figure 2. Layers of complexity within services.

Fearon P, Langhorne P, Early Supported discharge trialists. Services for reducing duration of hospital care for acute stroke patients. Cochrane Database of Systematic Reviews 2012, Issue 9. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000443.pub3/pdf [last accessed 8 Aug 2014]

 Google Scholar

Reablement: the added value of Occupational Therapists. London: College of Occupational Therapists; 2010. Available from: www.cot.co.uk/sites/default/files/position_statements/public/positionstatement-reablement.pdf [last accessed 13 Aug 2014]

 Google Scholar

National Service Framework for older people. London: Department of Health; 2001. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/198033/National_Service_Framework_for_Older_People.pdf [last accessed 13 Aug 2014]

 Google Scholar