There has been increased focus on improving care coordination and transitions across the care continuum, due, in part, to the recent health care legislation focused on improving patient outcomes and reducing costs in post-acute care. In this course, Dr. Barbara Lutz discusses the impact of current U.S. health care policy on transitions of care for patients recovering from stroke, and explores stroke survivor outcomes across different post-acute care settings. She discusses the implications of the Impact Act of 2014 and describes existing transitional care models, with suggested applications to post-acute care for patients recovering from stroke.
Dr. Barbara Lutz is the McNeill Distinguished Professor at the University of North Carolina-Wilmington School of Nursing. Her 30+ year career as a rehabilitation and public health nurse spans practice, research, education, and service. Her research focuses on understanding the needs and experiences of patients with stroke and other chronic illnesses and their family caregivers as they move through the continuum of care, from acute care to home. The goal of her work is to engage patients and their family caregivers in developing person and family-centered, community-based interventions for people with stroke and other chronic illnesses. She is a Co-Investigator on a PCORI-funded research study to test a person-centered, community-based Emergency Department (ED) to Home transitional care intervention developed in partnership with a research team that includes former patients, family caregivers, social workers, ED physicians, staff of 2 local Area Agencies on Aging, and health services researchers. Dr. Lutz is a Fellow in the American Academy of Nursing, American Heart Association (AHA), and National Academies of Practice. She is a board member of the Association of Rehabilitation Nurses and is a co-author on a position paper on the transitional care needs for patients needing rehabilitation services and on AHA scientific statements on palliative care in stroke, risk adjustment for stroke, and best evidence on stroke caregiver interventions. She has also served as a member of the ANA Care Coordination Quality Measures Steering Committee and as a rehabilitation expert on the Joint Commission Technical Advisory Panel for Comprehensive Stroke Center Certification.
The first chapter of this course discusses current health policies related to stroke. Dr. Barbara Lutz begins by examining the effect of the Affordable Care Act and the Impact Act on care transitions in stroke. She compares stroke survivor outcomes across different types of post-acute care settings and identifies opportunities to improve care transitions for stroke survivors.
Chapter 2 provides an overview of the different types of care transitions that may occur post-stroke. Dr. Lutz compares outcomes for stroke survivors across different post-acute care sites and discusses the role of the occupational therapist, or rehabilitation professional, in facilitating care transitions.
The final chapter of this course provides a comparison of transitional care models and implications for practice. Dr. Barbara Lutz evaluates evidence-based transitional care models in acute care and provides research regarding the models.