Allied Health (AH) taking the lead to make a difference in improving communication and length of stay with complex stroke care

Ms Shereen Mouafi1

1St George Hospital, Kogarah, Australia

Patients admitted to St George Hospital who sustained a complex stroke were more likely to have a length of stay (LOS) of more than seven days compared to peer hospitals across New South Wales (NSW).

AH led the Multi-Disciplinary Team (MDT) to foster a culture of trust as the foundation to initiate and maintain changes in practice to improve the processes of patient care. By finding a common purpose and identifying an aim statement of reducing the LOS by 10% for complex stroke patients, the MDT generated solutions to overcome the three primary barriers that were identified as key issues that inhibited patient care – poor communication within the MDT, poor communication between the MDT and consumers and poor processes on the ward.

Through collaboration with medical, nursing and AH team members, AH led the MDT to identify solutions to achieve the aim. Team communication and improving role recognition was addressed by introducing individual photos of professionals displayed on the ward. Improved patient planning was targeted by ensuring direct communication with consultants with the introduction of a complex case conference. If discharge or rehab was not identified as a suitable or safe solution in complex case conference meetings, a family meeting was conducted to aid with improving communication directly with consumers, assisting to re-align patient prognosis and expectations. AH developed and introduced visual goal mapping charts to assist consumers to understand expectations and short-term goals to assist with discharge planning. The medical model of care also changed following feedback from the MDT to assist with improving processes of patient care.

Solutions were implemented, monitored and measured over a 9-month period and resulted in a 17% reduction in LOS for complex stroke patients. Consistent positive feedback was also received from consumers and staff in relation to communication, transparency and education.


Shereen Mouafi is an Occupational Therapist working in the field of Neurology at St George Hospital. Shereen has a keen interest in leadership and quality improvement and using both these tools to improve team work and patient care. Shereen also has an interest in improving clinicians confidence in cognitive assessment and intervention.

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