{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T11:36:55Z","timestamp":1792496215678,"version":"4.5.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Evidence-based rehabilitation and secondary prevention interventions improve poststroke functional recovery and reduce secondary complications. However, stroke rehabilitation expertise, processes of care, and educational resources vary among sites where postacute care (PAC) is delivered. The American Heart Association developed quality standards based on the American Heart Association 2016 Guidelines for Adult Stroke Rehabilitation and Recovery to address these gaps. An interdisciplinary PAC standards writing committee identified key areas for PAC: quality improvement, medical management, care coordination, patient\/caregiver and personnel education, and program management. Subgroups developed draft standards, combining results from a national landscape survey of PAC sites with clinical practice guidelines. The committee then refined the draft standards using a consensus-based process. American Heart Association staff and PAC sites in Montana convened a learning collaborative to gather feedback and provide gap analyses of the standards relative to current practices. Qualitative input from beta testing in Montana and quantitative results from the nationwide survey and Montana sites were analyzed and used to refine the standards further. The national landscape survey demonstrated that most sites do not meet the proposed standards: stroke program oversight structure (78% fall short), stroke rehabilitation leadership (70%), stroke-specific order sets\/protocols (61%), and policies requiring staff stroke education (66%). Regarding Montana findings, 41% of the PAC sites have no mechanisms to identify areas of quality improvement specific to their stroke rehabilitation programs, and 59% do not use standardized tools to ensure that performance improvement initiatives are followed. However, with adequate support and resources, most Montana sites stated that they would be able to meet the proposed standards. We conclude that the Stroke PAC Quality Standards are applicable in PAC settings and provide a pathway to improving access to high-quality care for stroke survivors. Outcome studies are needed to confirm anticipated improvements in medical and functional outcomes.<\/jats:p>","DOI":"10.1161\/strokeaha.124.048942","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T18:01:02Z","timestamp":1748023262000},"page":"1650-1654","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["American Heart Association Standards for Postacute Stroke Rehabilitation Care"],"prefix":"10.1161","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5527-025X","authenticated-orcid":true,"given":"Joel","family":"Stein","sequence":"first","affiliation":[{"name":"Department of Rehabilitation and Regenerative Medicine and Department of Rehabilitation Medicine, Columbia University Vagelos College of Physicians and Surgeons, and Weill Cornell Medicine, New York, NY (J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9378-7209","authenticated-orcid":true,"given":"Samuel M.","family":"Bierner","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation (S.M.B.), University of Nebraska Medical Center, Omaha."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3879-2950","authenticated-orcid":true,"given":"Steve","family":"Dentel","sequence":"additional","affiliation":[{"name":"American Heart Association, Dallas, TX (S.D., M.P., K.P., J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly","family":"Downs","sequence":"additional","affiliation":[{"name":"Dakota Alpha, HIT, Inc, Mandan, ND (A.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5255-6911","authenticated-orcid":true,"given":"Mark","family":"Kovic","sequence":"additional","affiliation":[{"name":"Occupational Therapy Program, College of Health Sciences, Midwestern University, Downers Grove, IL (M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1308-7312","authenticated-orcid":true,"given":"Barbara J.","family":"Lutz","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Health and Human Services, University of North Carolina Wilmington (B.J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Pawloski","sequence":"additional","affiliation":[{"name":"American Heart Association, Dallas, TX (S.D., M.P., K.P., J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie","family":"Picou","sequence":"additional","affiliation":[{"name":"American Heart Association, Dallas, TX (S.D., M.P., K.P., J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janna","family":"Pietrzak","sequence":"additional","affiliation":[{"name":"American Heart Association, Dallas, TX (S.D., M.P., K.P., J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Pugh","sequence":"additional","affiliation":[{"name":"Stroke Unit, University of Maryland Rehabilitation and Orthopedic Institute, Baltimore (S.P.)."},{"name":"Moffett &amp; Sanders School of Nursing, Samford University, Birmingham, AL (S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Volkman","sequence":"additional","affiliation":[{"name":"Division of Physical Therapy Education (Emeritus) (K.V.), University of Nebraska Medical Center, Omaha."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristy","family":"Weissling","sequence":"additional","affiliation":[{"name":"Department of Special Education and Communication Disorders, University of Nebraska-Lincoln (K.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Zorowitz","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Georgetown University School of Medicine, MedStar National Rehabilitation Network, Washington, DC (R.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-3253","authenticated-orcid":true,"given":"Pamela W.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Neurology (Emeritus), Wake Forest Baptist Health, Winston-Salem, NC (P.W.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.00043"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06159-z"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.04.028"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2012.09.033"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/hs0102.101014"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.16646"},{"key":"e_1_3_2_8_2","volume-title":"Comparing Recovery Options for Stroke Patients","author":"Bettger JP","year":"2019","unstructured":"Bettger JP, Thomas L, Lang L. 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