Early Stroke Discharge (ESD) Program

We have a multidisciplinary team made up of the following disciplines who work together with the client to deliver a person centred care plan:

• Rehabilitation physician
• Stroke nurse
• Physiotherapy
• Speech Pathology
• Occupational Therapy
• Social Work
• Dietetics (from CRP)
• Neuropsychology
• Allied Health Assistants

Client Eligibility for ESD Program:

• Mild or moderate severity stroke (severe stroke on discussion with team leader/ESD team)
• Spontaneous subarachnoid haemorrhage (i.e. caused by AVM or aneurysm)
• Medically stable
• Reside within the EH catchment
• Making frequent rehab gains
• Have clear rehab goals that require intensive input and are achievable within a short time frame
• Ability to tolerate and commit to an intensive rehab program
• Safe home environment set up on discharge
• Patient consents to the program
• Requires input from PT, OT or SP (single discipline referrals accepted for these disciplines only)
• Patient able to mobilise out of bed safely ± family/carer assistance / equipment (e.g. sara steady)

*Mild severity stroke: NIHSS 1-4 / FIM >80
Moderate severity stroke: NIHSS 5-15 / FIM 40-80

Exclusion criteria

• Subdural haemorrhage and traumatic SAH or intracranial haemorrhage

Preferable:

• Able to safely attend Peter James Centre or Angliss Hospital for medical and some therapy appointments (discussion with team leader/ESD team if unable to attend the centre)
• Have transport available

Please contact the ESD Team Leader on 0428991571 to discuss a potential referral before completing the referral form.

Please note Eastern Health referrals will be given priority over those from external health services.

Referral Form (DOC,99KB)

Catchment Areas (DOC,22KB) 

There may be a small cost for our service, which we will explain to clients when we call to discuss your treatment plan.

We understand that covering the cost of health can be hard, even if you received the service in a public hospital. If you are worried that you may not be able to pay, please let us know at your initial intake phone call.