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Published Online
on July 17, 2008

Stroke. 2008
Published online before print July 17, 2008, doi: 10.1161/STROKEAHA.107.501064
A more recent version of this article appeared on September 1, 2008
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Submitted on August 2, 2007
Revised on January 7, 2008
Accepted on January 28, 2008

Optimizing Stroke Systems of Care by Enhancing Transitions Across Care Environments

Jill I. Cameron PhD*; Chris Tsoi MD(c); and 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.

* To whom correspondence should be addressed. E-mail: Jill.Cameron{at}utoronto.ca.

Abstract—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