Background
Ongoing rehabilitation post-stroke leads to further functional gains and prevents decline.  Unfortunately accessing rehabilitation in the community can be challenging due in part to limited discharge destinations from outpatient programs.  Adult Day Programs (ADP’s) are an underutilized component of stroke recovery that can support rehabilitation by providing opportunities to maximize function and socialization beyond the formal outpatient journey.  

Methods

Based on the successful OneCare Stroke ADP model in Clinton Ontario, the Southwestern Ontario Stroke Network (SWOSN) collaborated with partners and received funding from the South West Local Health Integration Network (SW LHIN) to spread Stroke ADPs across the region.  Work included developing an implementation strategy, a site analysis based on demand modeling, and the creation of referral pathways and processes.  The programs partnered with existing Community Stroke Rehabilitation Teams (CSRT) to enhance transitions, and support ADPs with best practices, standardization and evaluation.

Results
This work led to the creation of 4 Stroke ADPs, improving geographical access and improved outcomes for patients by providing rehabilitation following formal outpatient services.  Congregating stroke survivors on a specific day, allows for social integration, opportunities for peer/caregiver support, a focused opportunity for secondary stroke education, and a modified/specialized group exercise program catered to stroke survivor needs.


Conclusions
With limited funding, stakeholder partnerships led to the development of new programs that improve access, equity and outcomes, while providing an exit strategy from formal rehabilitation.  Stroke ADP days support system flow, provide caregiver relief and enable stroke survivors to maintain independence and re-engage in their community.

INNOVATIVE PROGRAMS CREATING OPPORTUNITIES FOR ONGOING STROKE RECOVERY IN THE COMMUNITY