Patients who have used StrokeLINK, a new Sláintecare funded service, run by the Mater Hospital supporting stroke patients in Dublin North City and County, have praised the new service. Helping patients stay healthier at home for longer and avoid hospital visits,  StrokeLINK specialist nurses connect with patients before they leave hospital, and guide them through the discharge process.

The nurse then follows up with the patient 48 hours post discharge and at regular intervals between then and the routinely scheduled three month medical check up. The nurses are also available as a point of contact to respond to issues as they arise.  This support has seen a remarkable increase in the level of self monitoring of blood pressure by patients – going from 58% to 97% following the introduction of the service.

 Reassuring

During its first few months of operation StrokeLINK has supported over 140 patients to manage their condition. Acknowledging the positive impact of the service, Patricia, a StrokeLINK patient said: “To have had that experience, and think if this is to happen again, what should I do, what should I not do…all my questions were answered clearly. They were very reassuring”.

The liaison between the nurses and the patient works very well as Lauren McDunphy, a StrokeLINK specialist nurse explains:  “Text messages and email reminders, a contact phone number for a StrokeLINK nurse, and liaison between StrokeLINK nurse and GP/Public Health Nurse/Primary care team all help patients to feel confident in managing their condition.  It helps them stay as well as they can at home and in their community. We have seen amazing results so far.

“We have seen  100% of StrokeLINK patients linking in with their GP in the weeks following their stroke compared with 68% before StrokeLINK. We also established that 98% of patients rated their discharge-related care as excellent compared with 63% before StrokeLINK”.

Book for patients, families and carers

Patients and their families and carers also receive a book that helps them understand their stroke and to encourage them to do the things that will speed their recovery and keep them well. The Stroke Nurse Specialists introduce the book while patients are in “hospitals and use it during phone calls and home visits.”

According to Consultant Neurologist Dr. Michael Marnane 40% of people will be re-admitted to hospital within two years of their first stroke: “StrokeLINK can help prevent many of these admissions by giving people the tools they need to change their lifestyle, and to engage with the advice they’ve been given in hospital. The clinical care model and engaging tools developed for StrokeLINK have huge potential to be adapted for other chronic disease management contexts -  heart disease, hypertension, chronic kidney disease, diabetes mellitus and chronic lung disease.”

Accessible information

The team at the Mater worked with designers at the National College of Art and Design to make patient information clear and accessible. Before StrokeLINK, despite the best efforts of the team, Stroke patients often seemed unsure what to do to take care of themselves. “This is really common in healthcare – clinical staff do their best but patients often feel overwhelmed with information or completely lost and powerless. The National College of Art and Design interaction designers really helped us crack this – to deeply understand what patients need and co-design a service and tools that really work for them” says Dr. Marnane.

Further remarkable benefits have seen 93% of patients report making healthier dietary choices compared with 42% before StrokeLINK while 95% reduced their alcohol intake, compared with 51% and 67% stopped smoking compared with 14% before StrokeLINK.