Abstract Body: Background: The transition period after hospitalization for stroke is a vulnerable time for patients as all adapt to new physical, cognitive, or emotional changes and destabilized comorbid conditions. Transitional care programs designed for post-stroke care carry the promise of improved outcomes and reduced hospital readmission rates, however attendance rates to these scheduled visits in other stroke early supported discharge programs are reported as low as 35%. In addition to patient specific consequences, missed stroke clinic visits impact system efficiency and workflow which carry broad regional consequences. We sought to understand the impact of our early supported discharge program on hospital length of stay and clinic attendance patterns to prepare for ongoing iteration of this program.

Methods: All hospitalized stroke patients who are discharged to home are enrolled in the Joint Stroke Transitional Technology-Enhanced Program (JSTTEP) and seen by a stroke specialist using telemedicine platform within the first 2 weeks of hospital discharge. Following JSTTEP, patients receive usual care which includes a stroke clinic visit 2-3 months after discharge, either by telemedicine or in-person based on patient preference and clinical needs.

Results: There has been no change in demographics since the inception of JSTTEP in 2020 with the average age of patients 61 years, 40% female, and nearly 50% black. In calendar year 2023, 309 patients were enrolled in the JSTTEP following hospitalization for acute stroke. Of those, 277 (90%) completed the first JSTTEP telemedicine visit. The mean time from hospital discharge to the first JSTTEP visit was 7.6 days. Hospital length of stay has decreased from 4.5 days prior to JSTTEP to 4.0 days in 2023. Modified Rankin Scale scores at 90 days decreased from 2.2 to 1.1 in a subset of patients with available scores.

Conclusion: Since the implementation of JSTTEP, hospital length of stay has decreased for stroke patients who are discharged to home. We note a high show rate to this clinic and suspect that there are a variety of contributors to these successes including close proximity to hospitalization, rapid attention to evolving post-discharge needs, interaction with stroke specialists, and use of telemedicine to facilitate access during a time period where driving is prohibited. The intentional design of the JSTTEP resulting in high level of engagement is likely a strong factor in the early success of the JSTTEP program.