| All settings |
Identification of patients with problematic spasticity within routine stroke care settings across the pathway. “Indicators for specific specialist spasticity review and possible treatment” have been identified and the corresponding acronym, “ACTION” (see Fig. 2), has been developed
|
| Acute care |
Appointment of an experienced HCP on the acute ward to act as a “spasticity champion” by liaising with specialist rehabilitation teams and taking responsibility for transfer of knowledge and skills to acute care staff Identification of patients at high risk of developing spasticity based on the criteria of severe stroke plus 2 or more of the following: severe motor weakness, severe sensory loss, communication impairment, unwell with other medical presentations, frailty, and neuropathic and/or other pain “Flagging” of high-risk patients to stroke and community teams, to facilitate close monitoring of spasticity onset prior to and after discharge from hospital Patient education (patient awareness and self-management) and their carers on the signs of spasticity, treatments available and action to take if they experience symptoms, through a pre-discharge meeting with a member of the acute team and provision of patient information Provision of a patient passport containing details of the patient’s stroke, spasticity and any treatment(s)
|
| Community care |
Inclusion of “indicators for action” in a pre-clinic screening questionnaire for patients to complete with assistance from an HCP (if necessary) prior to follow-up appointments Telephone triage services allowing community HCPs to seek advice from specialist spasticity services regarding patients Improve access to spasticity expertise by enabling specialist spasticity practitioners to carry out community visits Using existing online training resources to improve knowledge of spasticity among HCPs in the community |
| Specialist spasticity services |
Telephone triage/email services to allow community HCPs to seek advice from specialist spasticity teams regarding patients Telephone consultations to improve follow-up of patients in the community who find it difficult to access specialist services due to travel difficulties Enabling specialist spasticity practitioners normally based in clinics to visit patients in the community (to assess patients and review results of treatment) |
