6th Edition of Neurology World Conference 2026

Abstract

Prolonged hospital length of stay (LOS) in stroke units is associated with increased healthcare costs, delayed patient flow, and a higher risk of complications such as infections, aspiration, and falls. Efficient discharge planning is essential to optimise patient outcomes and healthcare resource utilisation. This quality improvement (QI) project aimed to identify factors contributing to prolonged LOS and evaluate targeted interventions to reduce discharge delays in a stroke unit. A two-cycle audit was conducted. The first cycle involved retrospective review of patients admitted with stroke between October and November 2023. Data collected included demographics, comorbidities, discharge pathways, mental capacity assessment (MCA) status, and causes of delay. Key delays were linked to Best Interest Meetings (BIMs) required for patients lacking decision-making capacity. Interventions included earlier multidisciplinary discussions and the use of telecommunication for BIMs. A second cycle in February 2025 assessed outcomes based on meeting format. In the first cycle, most patients had LOS exceeding 14 days. Patients lacking capacity had significantly longer admissions compared with those who retained capacity. Major contributors to delays included arranging Plans of Care, organising BIMs, and awaiting placement. Prior to intervention, BIM delays averaged 14 days. Following telecommunication implementation, delays reduced to approximately seven days via video conferencing and 0–1 days via telephone. 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.