Speakers - 2026

Title: Reducing Length of Stay in Stroke Patients Through Improved Discharge Planning: A Two-Cycle Quality Improvement Audit

Abstract

Prolonged hospital length of stay (LOS) in stroke units is associated with increased healthcare costs, delayed patient flow, and higher risk of complications such as infections, aspiration, and falls. Efficient discharge planning is essential to optimise patient outcomes and resource utilisation. This quality improvement (QI) project aimed to identify factors contributing to prolonged LOS and evaluate targeted interventions to reduce discharge delays.

A two-cycle audit was conducted. The first cycle involved retrospective review of stroke admissions between October and November 2023, analysing demographics, comorbidities, discharge pathways, mental capacity assessment (MCA) status, and causes of delay. Key delays were linked to Best Interest Meetings (BIMs) for patients lacking capacity. Interventions included earlier multidisciplinary discussions and the introduction of telecommunication for BIMs. A second cycle in February 2025 assessed outcomes based on meeting format.

Initially, most patients had LOS exceeding 14 days. BIM delays averaged 14 days. Following intervention, delays reduced to approximately seven days with video conferencing and 0–1 days with telephone discussions. Functional outcomes improved, with mean modified Rankin Scale decreasing from 3 to 1.3.

This project demonstrates that telecommunication strategies can significantly reduce discharge delays, improve efficiency, and enhance stroke patient outcomes.

5. Audience Takeaways

- Understand key causes of delayed discharge in stroke patients
- Learn how telecommunication can improve multidisciplinary decision-making
- Apply QI methodology to reduce hospital LOS in their own practice
- Improve patient flow and reduce healthcare system burden
- Implement practical, scalable digital solutions in clinical settings

Application: The audience will be able to apply teleconferencing strategies in discharge planning, improve workflow efficiency, and enhance patient outcomes in stroke and general medical services.