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(Stroke. 2008;39:2637.)
© 2008 American Heart Association, Inc.

Topical Review

Optimizing Stroke Systems of Care by Enhancing Transitions Across Care Environments

Jill I. Cameron, PhD; Chris Tsoi, MD(c) Amanda Marsella, BSc, MSc(c)

From the Department of Occupational Sciences and Occupational Therapy (J.I.C.), University of Toronto; the Toronto Rehabilitation Institute (J.I.C.); the Graduate Department of Rehabilitation Science (J.I.C., A.M.), University of Toronto, Toronto, Canada; and the Department of Medicine (C.T.), McMaster University.

Correspondence to Dr Jill Cameron, Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Ave, Toronto, Ontario, M5G 1V7, Canada. E-mail Jill.Cameron{at}utoronto.ca

Renee Lyons MD Section Editors Anthony Rudd MD

Stroke affects many aspects of the lives of stroke survivors and their family caregivers. Supporting long-term recovery and rehabilitation are necessary to help stroke survivors adapt to living with the effects of stroke and to help family members adapt to the caregiving role. During recovery and rehabilitation, many elements of the health care continuum are utilized, including emergency response, acute care, inpatient and outpatient rehabilitation, and community and long-term care. With the advent of thrombolytic therapy and the benefits of stroke units, stroke survival and outcomes are improving. As a result, the current emphasis of stroke system improvement is to implement stroke units throughout the developed world. To enhance the patient centeredness of stroke care delivery, an important next phase of stroke system improvement will center on the experiences of stroke survivors and their family caregivers as they move through diverse care environments. The objective of this article was to conduct a scoping review of the literature on stroke transitions to identify the current areas of research emphasis. This article highlights stroke survivors’ and family caregivers’ experiences with transitions across care environment and some potential strategies to improve those transitions.

Key Words: stroke • system of care • continuity of care • transitions