Aphasia Rehabilitation Service Delivery in a Stroke Rehabilitation Unit in Australia: A Clinical Audit of Speech Pathology Practices

Abstract

Purpose: To investigate service delivery of aphasia rehabilitation in a metropolitan rehabilitation hospital by speech pathologists and assess adherence to both the National Stroke Foundation (NSF) Clinical Guidelines and the Australasian Rehabilitation Outcomes Centre (AROC) database of benchmarks. Method: A retrospective audit of 34 discharged patients was conducted within a dedicated stroke rehabilitation unit from March 2012 to July 2013 in Australia. Discharge reports, Functional Independence Measure (FIM) scores and clinical time statistics derived from the organization’s electronic database were studied and compared with NSF’s Clinical Guidelines for best practice recommendations and AROC benchmarks. Results: Patients with aphasia were admitted to inpatient rehabilitation at an average of 21 days post stroke, 2 days beyond the AROC benchmark for inpatient rehabilitation. The mean length of stay of patients with aphasia was 60 days, significantly longer than the average AROC benchmark of 32.8 days. Patients received an average of 4.25 hours of speech pathology therapy per week, more than twice the minimum amount of therapy time recommended by the NSF Guidelines. Conclusion: The current clinical audit is the first known speech pathology audit investigating adherence to stroke and aphasia rehabilitation guidelines set forth by the NSF clinical guidelines and AROC benchmarks in Australia. By comparing current care with advocated best practice, strengths were identified in service delivery, as well as priority areas for quality improvement.