Six-Month Review of the Occupational Therapy Service within the Stroke Early Supported Discharge Service at an Acute Dublin Hospital

Abstract Background Early Supported Discharge (ESD) is an evidenced based international model of best practice for stroke patients (National Stroke Strategy, 2022-2027). The National Clinical Guidelines for Stroke (2023), stipulate that patients with mild to moderate impairments post stroke should be offered ESD. The purpose of this occupational therapy (OT) service review is to evaluate current practices and to identify quality improvement opportunities to enhance OT service delivery. Methods A retrospective data analysis was conducted over a six-month period, encompassing Q4 2024 and Q1 2025. Data was gathered from secure ESD OT logbooks and OT statistics, focusing on key metrics including referral numbers and performance indicators. The analysis also examined the most frequent OT interventions delivered, number of onward referrals, and quality improvement opportunities. Results Between October 2024 and March 2025, 30 referrals were accepted by the OT service. Of these referrals, 64% were aged over 65 years. Initial contact was made within 24 hours of discharge for 74% of referrals. The primary OT interventions delivered, listed from most to least frequent, included fatigue management, cognitive rehabilitation, activities of daily living, upper limb, return to driving, perceptual retraining, community access, vocational rehabilitation, and vision rehabilitation. Following ESD, 30% of patients required onward referral to community-based stroke services. Conclusion The following areas for quality improvement were identified;