Abstract TMP42: Enhancing Stroke Rehabilitation: A Quality Improvement Initiative

Background: Ischemic strokes occur due to a blood supply blockage in one of the brain’s blood vessels, and Hemorrhagic strokes occur when one of the brain’s blood vessels ruptures. The American Stroke Association cites strokes as the fifth leading cause of death in the United States. This study aimed to determine the average minutes needed for patients to achieve their Medicare-calculate goals at our inpatient rehabilitation program. Methods: A retrospective study of 393 patients with stroke (age > 18: 209 men, 184 women) that received either 3 hours of therapy 5 days per week or 2 hours and 20 minutes of therapy 7 days a week for the length of their stay in our program from January 2021-December 2023. Results: Main outcome measures were the Medicare calculated self-care and mobility scores on admission and on discharge. 283 patients met at least one of their Medicare calculated discharge goals. Those that met their self-care goals needed less PT, OT, and ST minutes. They also had a higher AMS than those that did not meet their self-care goals. Those that met their mobility goals required more PT, OT, and ST minutes, and had a higher AMS than those that did not meet their mobility goals. Those that met both their self-care and mobility goals required more PT and OT minutes, less ST minutes, and had a higher AMS. Discussion: ST minutes were an independent predictor of whether people would meet their self-care goal. Patients with higher BMIs were not likely to meet their mobility goal. Patients with a higher AMS were more likely to meet their mobility goal. BMI and AMS were independent predictors of whether people met their mobility goal. There were no independent predictors as to whether patients would meet both their self-care and mobility goals. Those achieving their self-care goal needed an average of 831.5 minutes (PT), 826.8 minutes (OT), and 397.2 minutes (ST). Those achieving their mobility goal needed an average of 845.8 minutes (PT), 833.7 minutes (OT), and 403.8 minutes (ST). Those achieving both their self-care and mobility goals needed an average of 835.5 minutes (PT), 830.3 minutes (OT), and 417.1 minutes (ST). Conclusion: Stroke patients are more likely to meet their Medicare-required self-care goals if they require less ST minutes. Patients with a higher BMI and lower AMS score are less likely to meet their Medicare-required mobility goals. There was not an independent predictor for patients that met both their self-care and mobility goals.