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Table 1 Project questions

From: Standardising evidence strength grading for recommendations from multiple clinical practice guidelines: a South African case study

 1. Which factors might delay admission to medical facility after suffering a stroke at home? c

 2. What is the optimal time for referral to rehab since admission to hospital? 4,3,2,1

 3. What is the optimal time for commencement of rehab since suffering a stroke? 4,3,2,1

 4. What are the factors indicating when it’s safe for rehab to commence? 4,3,2,1

  • EB assessment planning 4,3,2,1

   • Which factors should be assessed?

   • Which outcome tools should be used?

 5. Best practice recording method for assessment, treatment and goal setting when treating a stroke patient? 4,3,2,1,h,p

 6. What is critical to record when assessing and treating a stroke patient? 4,3,2,1, h, s

 7. What is the best, locally relevant communication platform for improving communication between levels of care; medical personnel; therapists; therapist/patient; therapists/family; therapist/employer? 4,3,2,1, h, s

 8. What should be communicated with medical personnel, other rehab therapists, patient and carer/family? 4,3,2,1,h,p

 9. What are the EB guideline on setting rehab goals and how to record these goals? 4,3,2,1, h, s

 10. EB discharge planning: 4,3,2,1, h

  - When should it start for a stroke patient?

  - Who should be involved?

  - What should it include?

 11. Which rehab professional should first see the patient? 4,3,2,1, h

  • What is the EB most critical first step?

  • What are the EB criteria for referral between therapists?

  • What is the best practice communication between therapists (devises, discharge planning and care continuation)?

 12. According to the evidence, which therapist should communicate with the family? 4,3,2,1, h, s

 13. What is the EB role of the physiotherapist, occupational therapist and speech therapist when assessing and treating a stroke patient? 4,3,2,1

 14. How does the model of care differ between the different points of entry (primary; secondary; tertiary; quaternary level)? 4,3,2,1

 15. What are the EB rehab interventions at each level of care? 4,3,2,1, h, s

 16. What are the best outcome measures for SA context for all levels of care as well as urban, suburban and urban settings? 4,3,2,1, h, s

 17. When should family education commence? 4,3,2,1, h, s

  • Which communication channel is most appropriate?

  • How is family incorporated into discharge planning?

  • Who should be communicating?

  • What should be included in the communication and in which format?

 18. What is the EB criteria for referral to other professions such as social workers/psychologists? 4,3,2,1, h, s

 19. Which rehab professional should take responsibility for planning and monitoring continuation of care? 4,3,2,1, h, s

 20. What are the EB rehab criteria for discharge from rehab as an in-patient and out-patient? 4,3,2,1, h, s

 21. What is the EB information for the best next level of care? 4,3,2,1, h, s

 22. What are the EB interventions for longer term care h, s

  – rehab facility

  – Community Health Center (CHC)

  – long term home care

  – home or community

 23. What are the EB ways of communicating with patient/family/other professionals? 4,3,2,1, h, s

 24. What are the EB rehab outcome measures for longer term care? h, s

 25. What is the EB education linked to complications of stroke (aspiration pneumonia/ secondary strokes etc.) 4,3,2,1, h, s

 26. How should Traditional healers be incorporated into the medical system? c, h

 27. What training should traditional healers received to appropriately refer a stroke patient? c,h

 28. What are EB criteria for ending rehab? h, s

  • Ongoing monitoring?

 29. What is the evidence for the swallow test? When should it be done and by whom? 4,3,2,1

 30. What are the EB criteria for assistive technology? 4,3,2,1, h, s

  – Walking Aids

  – Slings

  – AFO’s

  – Wheelchairs

  – Splints

  – OT tools???

 31. What is the EB approach to re-integrating stroke patient into the community, society, leisure and work (participation)? h, s

 32. How should rehab therapists liaise with other sectors (transport/labour/social) for facilitated participation? h, s

 33. How should the community/general public be educated to facilitate societal participation of a person who has suffered a stroke? h, s

 34. Therapists are not trained for inter-sectorial integration when it comes to general care/rights of a person who has suffered a stroke. What is the best practice to address this issue? h, s

 35. “Work hardening”; aerobic capacity, effort and tolerance: 4,3,2,1, h, s

  - When should treatment or focus on these factors start?

  - What is the evidence based strategy to address this?

 36. Self-efficacy – compliance to medication and self-care:4,3,2,1, h, s

  - When should this start?

  - Which therapist should be responsible for educating patient?

 37. Best practice to work with mental health professionals or issues???? 4,3,2,1, h, s

 38. Best practice to equip/educate rehab therapist to deal with bereavement and depression after stroke? 4,3,2,1, h,

  1. Key: “c” refers to “Community”; “h” to “Home/long term care”; “s” to Society; “1” to “Primary”; “2” to “Secondary (District/Regional)”; “3” to “Tertiary”; and “4” to “Quaternary”