Occupational therapy predischarge home visits for patients with a ...

Research 

Occupational therapy predischarge home 

visits for patients with a stroke: what is 

national practice? 

Avril Drummond, 1 Phillip Whitehead, 2 Karen Fellows, 3 Claire Edwards 4 and Nikola Sprigg 5 

Key words: 

Stroke, research, 

occupational therapists, 

predischarge home visits, 

assessment, practice. 

1 Professor of Healthcare Research, Faculty of 

Medicine and Health Sciences, University 

of Nottingham, Queen’s Medical Centre, 

Nottingham. 

2 Research Associate, Division of Rehabilitation 

and Ageing, University of Nottingham, 

Nottingham. 

3 Research Occupational Therapist, Division 

of Rehabilitation and Ageing, University of 

Nottingham, Nottingham. 

4 Research Assistant, Division of Rehabilitation 

and Ageing, University of Nottingham, 

Nottingham. 

5 Diffusion Fellow/Clinical Associate Professor, 

Division of Stroke, University of Nottingham, 

Nottingham. 

Corresponding author: 

Professor Avril Drummond, Professor of 

Healthcare Research, Faculty of Medicine 

and Health Sciences, University of 

Nottingham, A Floor, Queen’s Medical 

Centre, Nottingham NG7 2HA. 

Email: Avril.Drummond@nottingham.ac.uk 

Reference: Drummond A, Whitehead P, 

Fellows K, Edwards C, Sprigg N (2012) 

Occupational therapy predischarge home 

visits for patients with a stroke: what is 

national practice? British Journal of 

Occupational Therapy, 75(9), 396-402. 

DOI: 10.4276/030802212X13470263980711 

© The College of Occupational Therapists Ltd. 

Submitted: 1 November 2011. 

Accepted: 14 February 2012. 

Background: Little is known about day-to-day procedures in conducting predischarge 

home visits in occupational therapy. The aim of this study was to identify current 

practice in relation to people with stroke. 

Method: A questionnaire was designed and piloted; 184 were posted to stroke 

units in England. 

Results: Responses were analysed from 85 stroke units from 10 regions. The 

main reason for conducting visits was to ‘assess or practise activities of daily 

living in the home environment’ (93%), closely followed by to ‘identify or address 

safety issues’ (92%). Wide variations exist in time spent on the actual visit (range 

10-135 minutes), with a mean time of 63 minutes (SD 20.36), and a mean time 

of 61 minutes (SD 33.13) for writing a report. Visits were generally conducted by 

an occupational therapist, with an occupational therapy/physiotherapy assistant. 

The majority (95%) of therapists reported having a home visit bag and the most 

common item included was incontinence pads (83%). 

Conclusion: This research has provided valuable information on, and highlights 

the variation in, day-to-day predischarge home assessment visits for patients after 

stroke. The next step must be to use this knowledge to evaluate patient selection 

and to examine the costs and effectiveness of such visits. 

Introduction 

The College of Occupational Therapists (1990) has defined a predischarge 

home visit as: 

… a visit to the home of a hospital in-patient which involves an occupational 

therapist/s in accompanying the consumer to assess his/her ability to function 

independently within the home environment or to assess the potential for the 

consumer to be as independent as possible with the support of carers (p1). 

A predischarge home visit differs from an access or environmental visit where 

the occupational therapist attends the property without the patient, or a discharge 

visit where the patient remains at home and does not return to the 

hospital with the occupational therapist. Within the occupational therapy 

literature, predischarge home visits are reported to be completed in order 

to address concerns about a change in functional ability due to the onset or 

progression of a particular medical condition or disease process (Welch and 

Lowes 2005) or to increase the safety of the patient following discharge home 

(Johnston et al 2010). 

Few papers on predischarge occupational therapy home visits have been 

published (Barras 2005). Patterson et al (2001) surveyed head occupational 

therapists in every National Health Service (NHS) trust admitting acutely ill 

older people in the United Kingdom and received responses from 239 trusts 

(90%). They reported that 65% carried out between 11 and 40 predischarge 

home visits per month, and 11% completed more than 60 visits per month. 

396 British Journal of Occupational Therapy September 2012 75(9)

Avril Drummond, Phillip Whitehead, Karen Fellows, Claire Edwards and Nikola Sprigg 

Thirty per cent completed home visits with more than half 

of all patients. An occupational therapist was present on 

all these visits. 

Lannin et al (2011) surveyed 215 public and private 

hospitals in New South Wales, Australia. They received 52 

responses, a 25% response rate, and reported an average of 

13 predischarge home visits per month (range 1 to 60). They 

also found that in 40 of the 47 departments that completed 

home visits, more than half of all patients had a visit. Home 

visits took an average of 1 hour and 20 minutes to complete 

and 2 hours including travel time. 

Figures from these publications suggest that predischarge 

home visits are a common component of occupational therapy 

for older people in acute care settings. With regard to stroke, 

data on home visits were recorded in the 2006 National 

Sentinel Stroke Audit, which reported that 73% of patients 

admitted to a stroke unit had a home visit before discharge 

(Intercollegiate Stroke Working Party 2007). Although this 

figure must be regarded cautiously (units were asked about 

visiting ‘appropriate’ patients and there may have been confusion 

in interpreting what this meant), it would seem that 

home visits are carried out routinely. However, little is known 

about current occupational therapy home visiting practice. 

It is unclear whether there are regional variations in the 

number of visits completed, who routinely attends the visits, 

how information collected on the visit is communicated, how 

much time they take, what basic equipment is taken and 

what the occupational therapist carries on the visits. 

Thus the aim of this study was to address this dearth of 

knowledge and to collect up-to-date information to describe 

the practice of predischarge home visits by occupational therapists 

working in inpatient stroke care. The research question 

was as follows: ‘What is routine occupational therapy practice 

when conducting predischarge home visits for patients 

with a stroke?’ 

Method 

Questionnaire 

As no suitable instrument already existed, a questionnaire was 

designed using previous literature in the field (Patterson et al 

2001, Lannin et al 2011) and input from local stroke clinical 

occupational therapists and from occupational therapy 

researchers. A copy of the questionnaire used by Lannin 

et al (2011) was also obtained and some of the questions in 

their survey were adapted (with their permission) for the 

purposes of this study. 

The questionnaire was designed to identify current 

practice in predischarge occupational therapy home visits 

following stroke and covered the following topic areas: 

1. Number of predischarge home visits completed – respondents 

were asked to calculate how many predischarge 

home visits were completed in their stroke unit during 

the months of April and May 2011. 

2. Occupational therapists’ reasons for conducting home 

visits – the occupational therapists were provided with 

a list of possible reasons for completing a predischarge 

home visit and asked to select all those that applied. 

3. Time spent on home visits – respondents were asked to 

report the average time spent completing home visits, 

including time spent at the home, travel time, organising 

the visit and writing up the home visit report. 

4. Procedures – those surrounding home visits and staff 

routinely attending the visit. 

5. Home visit reporting – what happens to the completed 

report in routine practice (respondents could select 

multiple options). 

6. Contents of a home visiting bag – respondents were 

asked if they routinely took anything else on a visit in 

addition to the contents of the home visit bag. 

Specific additional space was also provided for other 

comments; respondents were asked if there was anything else 

they would like to add about home visiting either (i) in the 

stroke unit where they worked or (ii) more generally relating 

to occupational therapy. 

Although the questionnaire related only to predischarge 

home visits (as defined above) and not to access or discharge 

visits, information was also collected on the number of 

these visits conducted. 

Piloting 

The questionnaire was initially sent to six local clinical occupational 

therapists, from two different hospitals, treating 

people with stroke. The questionnaire was also sent to 

four researchers with expertise in stroke research. No major 

revisions were made as a result of piloting, although several 

questions were rephrased to improve clarity, and the overall 

layout was revised to make the questionnaire more visually 

appealing and easier to complete. 

Procedure 

A list of 184 hospitals that had stroke units in England was 

obtained from the Royal College of Physicians National 

Sentinel Stroke Audit 2010 (Intercollegiate Stroke Working 

Party 2011). Questionnaires were posted with a covering 

letter explaining the purpose of the study and an addressed 

envelope for return of the completed questionnaire. The 

packages were addressed to ‘The Lead Occupational Therapist, 

The Stroke Unit’. The letter encouraged therapists to complete 

two questionnaires if there were two distinct parts to their 

service, for example, acute / hyperacute and rehabilitation; 

this could be done by contacting the authors for another copy 

or by photocopying the questionnaire themselves. In the covering 

letter, the occupational therapists were offered a certificate 

for continuing professional development in recognition that 

they had assisted with a stroke research project. 

Each questionnaire was given an identifiable code in 

order to ascertain the geographical spread of the sample of 

returned questionnaires. 

In addition, the study was advertised by emailing members 

of the specialist sections of the College of Occupational 

Therapists for older people and neurological practice 

(COTSS-OP, COTSS-NP) and by personal contacts. This 

British Journal of Occupational Therapy September 2012 75(9) 

397

Occupational therapy predischarge home visits for patients with a stroke: what is national practice? 

was to alert therapists to the survey arriving in their hospital, 

and to encourage them to complete it. 

Respondents were initially given 3 weeks to return the 

questionnaire. A further reminder was emailed to the 

COTSS-OP and COTSS-NP members. However, the final 

deadline was extended when several occupational therapists 

contacted the research team to say that they were returning 

their questionnaires later. No formal reminders were sent. 

Fig. 1. Regional distribution of respondents. 

Analysis 

When all the data had been collected, they were entered onto 

SPSS (version 16) for analysis using descriptive statistics. Two 

researchers were involved in the initial data coding (PW, CE). 

One researcher then entered the data (CE), which was double 

checked by another (PW). A random sample of 10% of the 

questionnaires entered was then checked (PW, KF) before 

the data were analysed. 

Ethical approval 

Ethical approval for the Home Visit after Stroke (HOVIS) 

study, including administering this questionnaire, was provided 

by Berkshire Research Ethics Committee in May 2010 

(reference 10/H0505/41). 

Results 

Sample 

Eighty-seven questionnaires were returned (response rate of 

47%) from 81 NHS sites (6 sites returned a separate questionnaire 

for both the acute and the rehabilitation units). 

However, 2 questionnaires were returned too late to be 

included, thus a total of 85 questionnaires was analysed. 

Responses were obtained from 10 regions in England, with 

the majority (16%) from the West Midlands. The geographical 

distribution of the stroke units is displayed in Fig. 1. 

Questionnaires were returned from a variety of clinical settings: 

29 mixed units (34%), 26 rehabilitation units (31%), 

26 acute units (31%) and 3 other types of unit (3%). This 

information was missing from one questionnaire (1%). 

The average number of beds on the stroke units was 24 

(n = 79, mean = 24.15, SD 9.23, range 8-76). In terms of the 

availability of community follow-up services, 69% of stroke 

units had a community intermediate care team, 55% had a 

community stroke team, 46% had neurological /stroke outpatients’ 

services and 43% had an early supported discharge 

team. The results are discussed under the topic headings used 

in the questionnaires. Please note that ‘missing’ responses are 

not always from the same respondent. 

Numbers of predischarge home visits 

completed 

The results are shown in Table 1 for all units combined and 

also split into acute, rehabilitation and mixed units. The average 

length of stay was 25 days (n = 62, mean = 25.18, SD 16.26, 

range 4-92). The average number of visits completed by all 

units in April and May combined was 7 (that is, approximately 

one per week). As expected, in the acute units the average 

number of visits was lower, with a mean of 3 in April and May 

combined. In the rehabilitation units, the average number 

of visits was higher: 12 in April and May combined. In the 

mixed units, the average was 8. Seventy-four per cent of units 

provided their actual figures, and 26% estimated the number. 

The respondents were also asked to calculate the proportions 

of patients who had a predischarge home visit from 

their stroke unit in April and May (combined). Seventeen 

(20%) stroke units did not complete any home visits during 

this period. Thirty-seven (44%) did complete home visits, 

but with 25% or fewer patients. Only 7 (8%) stroke units completed 

home visits with more than 50% of patients and these 

were all rehabilitation units. 

Occupational therapists’ reasons for 

conducting home visits 

The occupational therapists were provided with a list of 

possible reasons for completing a predischarge home visit 

and asked to select all those that applied. Table 2 shows the 

overall percentages of respondents who stated that they 

completed a home visit for these reasons. The main reason 

cited was ‘to assess or practise activities of daily living 

in the home environment’, selected by 79 (93%); 78 (92%) 

stated that they would do a visit to ‘identify or address safety 

issues’, and 75 (88%) stated that they would complete a 

visit to ‘assess or practise mobility or transfers in the home 

environment’. Occupational therapists were also given the 

opportunity to give free text responses as to the reasons 

for completing a home visit, and 39% did so. These reasons 

included: to increase patient’s insight; because of concerns 

about cognition, vision, orientation or perception; to decrease 

family anxiety; and to train carers. 



Table 1. Numbers of predischarge home visits completed 

Units Length of stay in days Number of home visits 

n Range Mean (SD) n Range* Mean (SD) 

Acute ........................................................17................4-22................12.65 (4.97)...........................25...............0-20...................2.52 (4.09)............... 

Rehabilitation ..........................................19..............21-60 ...............36.84 (11.75)...........................25...............1-27.................11.76 (7.68)............... 

Mixed......................................................24................8-92 ...............25.17 (18.59)...........................30...............0-20...................7.47 (5.70)............... 

Hyperacute ................................................1.................N/A ..................[21] ............................................1................N/A .....................[0]........................... 

Other.........................................................1.................N/A ..................[21] ............................................2...............0-8.....................4.00 (5.66)............... 

All units (Total) ........................................62................4-92................25.18 (16.26)...........................83...............0-27...................7.10 (6.93)............... 

*Visits in 2 month period (April and May 2011). [ ] only one response. 

NB. Twenty-three units did not provide information for length of stay; 2 units did not provide information for number of home visits. 

Table 2. Occupational therapists’ reasons for completing home visits 

Reason Frequency Percentage 

(n = 85) 

Assess/practise activities of daily living 

in home environment .........................................79...................93%........ 

Identify/address safety issues..............................78...................92%........ 

Assess/practise mobility/transfers in 

home environment .............................................75...................88%........ 

As part of discharge planning .............................66...................77%........ 

Carer concerns ...................................................63...................74%........ 

Assess access to and within property ..................63...................74%........ 

Increase patient’s confidence and mood..............59...................69%........ 

Equipment provision...........................................49...................58%........ 

Inform ongoing rehabilitation goals ....................42...................49%........ 

Other .................................................................33...................39%........ 

Obtain measurements ........................................31...................37%........ 

Stroke unit policy..................................................4.....................5%........ 

Missing (respondents who did not complete 

this question) .......................................................3.....................4%........ 

Time spent on home visits 

There was a wide range in average times reported. The average 

time spent at the home was 63 minutes (n = 84, mean = 62.88, 

SD 20.36, range 10-135); time writing the home visit report 

was 61 minutes (n = 84, mean = 61.05, SD 33.13, range 2-210); 

average time spent organising the visit was 50 minutes (n = 84, 

mean = 49.98, SD 34.58, range 10-240); and travel time to 

and from the hospital was 49 minutes (n = 84, mean = 48.70, 

SD 25.41, range 15-180). The total time spent completing one 

home visit (including preparation, travel and report writing) 

was an average of 223 minutes (n = 84, mean = 222.61, SD 76.28, 

range 100-570). This is approximately half a day of occupational 

therapy time (3 hours, 43 minutes). However, it should 

be noted that the figure of 570 minutes was an outlier; the 

next figures were grouped around 6-7 hours. 

Procedures surrounding home visits 

Seventy-four (87%) of the stroke units reported that it was 

hospital policy to have two staff members present on a home 

visit. An occupational therapist was present on all visits 

(either an occupational therapist or a senior occupational 

therapist) in all units. Other people who would routinely 

attend were: occupational therapy/physiotherapy assistants 

(93% of stroke units), family members (93%) and physiotherapists 

(60%). The most popular combination of staff 

attending a home visit was an occupational therapist with 

an occupational therapy/physiotherapy assistant (78%). 

The results are shown in Table 3. 

One occupational therapist noted that in her unit a risk 

assessment was carried out on patients and on this basis only an 

occupational therapist might attend the visit with the patient. 

The most common method of transport used for visits was 

a pool car (52% of stroke units); this was followed by a taxi 

(26%), ambulance (8%), staff member’s own transport (7%) 

and other transport methods (4%), for example, hospital 

transport with wheelchair access, mobility link transport 

and voluntary services (3% ‘missing’). 

Table 3. Staff present on home visits 

Who would be present on Frequency Percentage 

visits in addition to an 

occupational therapist? 

Occupational therapy/physiotherapy assistant..........79 ................93%....... 

Family member .......................................................79 ................93%....... 

Occupational therapy student ..................................61 ................72%....... 

Physiotherapist .......................................................51 ................60%....... 

Student (other discipline) ........................................43 ................51%....... 

Social worker/care manager ....................................31 ................37%....... 

Formal carer..............................................................19 ................22%....... 

Other.......................................................................15 ................18%....... 

Nurse .......................................................................8 ..................9%....... 

Speech and language therapist .................................7 ..................8%....... 

Home visit reporting 

Eighty-four (99%) of the stroke units reported that a report 

or form was routinely completed following a predischarge 

home visit. In all cases this was completed by the occupational 

therapist (or by an occupational therapy assistant with input 

from an occupational therapist). Eighty-three per cent of the 

units reported that this was a proforma report or form and 

12% reported that the format of the report was at the discretion 

of each individual therapist (5% missing). 

Seventy-five (88%) units filed the report in the patient’s 

medical notes, 47 (55%) filed it in the occupational therapy 

notes, 49 (58%) forwarded the report to other health service 


399


Fig. 2. What is in the home visit bag? 

Comments 

Seventy (82.5%) occupational therapists reported that, in their 

opinion, home visits were completed with the ‘right number’ 

of patients and 13 (15%) reported that home visits were completed 

with ‘not enough’ patients. There were no respondents 

who reported that home visits were completed with ‘too many’ 

patients (two respondents did not answer this question, 2.5%). 

Space was provided for any additional comments on home 

visiting and 72% (n = 61) took this opportunity. Interestingly, 

there were marked variations in the therapists’ opinions of 

visits. Some felt very strongly for visiting: 

Home visits are an essential part of practice as patients can 

present very differently in their own environment (039). 

I believe it should be made a policy that all patients that have 

had a stroke have a predischarge OT home visit (132). 

Unique still to OT … should be protected … and not become 

generic (042). 

Others felt that there were difficulties: 

There are often requests for visits which I feel are inappropriate 

(127). 

They are popular with patient and staff however they lack some 

understanding of how much time and effort they take (088). 

teams in the community, 20 (24%) sent a copy to the patient’s 

general practitioner, 12 (14%) gave a copy to a relative or 

family member, and 10 (12%) gave a copy to the patient. 

Contents of a home visiting bag 

Eighty-one (95%) of the stroke units reported having a home 

visit bag, which was taken on all home visits. The contents 

of the home visit bags are shown in Fig. 2. The most common 

items included in the home visit bag were incontinence pads 

(83%), gloves (76%), vomit bowl (73%) and apron (67%). 

Respondents routinely took other items in addition to the 

contents of the home visit bag. Sixty-five per cent took milk, 

21% took food, 21% took mobility aids/equipment, 15% took 

a mobile phone and 8% took tea bags. 

Other visits 

Respondents were also asked about the number of access 

visits (without the patient) and discharge visits (where the 

patient remains at home after the visit) completed in April 

and May 2011. The average number of access visits completed 

per unit in April and May combined was 7 (n = 83, 

mean = 7.20, SD 8.39, range 0-38). Of these figures, 61% provided 

their actual figures, 33% provided estimates and 6% 

did not indicate whether the figures were actual or estimated. 

The average number of discharge visits completed per unit in 

April and May combined was 1 (n = 82, mean = 1.39, SD 3.28, 

range 0-16). Eighty-one per cent of units provided actual 

figures, 11% provided estimates and 8% did not indicate 

whether the figures were actual or estimated. Although occupational 

therapists reported that access visits were conducted, 

40 (47%) said discharge visits would not be completed at all. 

I don’t think they [home visits] need to be carried out as a 

routine task (106). 

There were many comments that underlined that staffing 

was a real issue in deciding on whether or not to conduct a visit: 

I believe home visits are good practice for most stroke patients, 

but due to our staffing and pressures on length of stay we are 

only able to complete them rarely (150). 

I would like to do them more frequently but we are pressurised 

for time due to poor staffing (096). 

We would like to complete more home visits but limited by 

lack of time and staff (052). 

However, there were also comments about how early supported 

discharge (ESD) schemes and community services, in particular 

centres, had reduced the number of visits and how 

some units were starting to conduct more access visits than 

home assessment visits. 

Respondents made suggestions, which included involving 

other staff grades in visiting: 

[We should] explore the role of a band 4 to complete home 

visits (159). 

They also suggested involving staff from other disciplines: 

It is always assumed to be an OT role … there may be some 

instances when it could be more appropriate for another 

profession to lead the visit (039). 

We are developing the relationship with SaLTs that they attend 

visits when communication is a safety concern (055). 

… feel there is scope for other disciplines to increase their 

involvement in this (143). 



Some areas were identified where interesting initiatives 

had taken place in practice; for example, training specifically 

for conducting home visits: 

The unit … has set out HV competencies which must be 

achieved before each OT can conduct a HV without another 

OT being present (140). 

Another unit issued booklets on home visits, which explained: 

… why a home visit needs to be carried out and what happens 

on the home visit (057). 

Discussion 

This study attempted to determine routine occupational 

therapy practice for predischarge home visits after stroke. 

The survey suggested that there were marked variations 

between different units in terms of numbers of visits completed 

and time taken to complete visits, organise and write 

up. For example, with regard to actual time spent on visits, 

the average was 1 hour, but ranged from a surprisingly short 

10 minutes to over 2 hours. The total time spent on the whole 

process (preparation, travel, visit and administration) was just 

under 4 hours, but again the range was from 1 1 ⁄2 hours to 

9 1 ⁄2 hours. Although this upper figure was an outlier, there 

were still occupational therapists reporting totals of up to 

6 hours. Interestingly, the contact time (63 minutes) was 

similar to that reported in the Lannin et al (2011) paper 

which was 80 minutes, although this study was for older 

people and was not stroke specific. Probably one of the most 

striking figures from the present research was the amount 

of time spent by therapists in writing their reports rather 

than spending time in face-to-face contact with patients. 

With regard to actual number of visits, the figures are 

more difficult to interpret. A 2-month window was selected 

in case a month was chosen where the practice on the unit 

was not reflective of normal visiting. However, several 

respondents said that they felt a longer time band would 

have been better. The mean number over the 2 months 

was 7, that is, approximately one visit per week but, again, 

the range was large: the number of visits ranged up to 27. 

The figures, as anticipated, were low for acute units 

and higher for the rehabilitation units. The number of visits 

in this survey was lower than reported in the Lannin et al 

(2011) and Patterson et al (2001) papers and were lower than 

one would have predicted based on the sentinel audit data 

from 2006 (Intercollegiate Stroke Working Party 2007), where 

three-quarters of patients had a home visit. This suggests a 

reduction in the number of visits being performed across 

England, although it is not possible to confirm that with 

the data collected here. It is interesting to note how many 

therapists relied on an ‘estimate’ of their visits: this may be 

because they completed the questionnaire without access 

to the data or, perhaps, that their unit did not record this 

information. This information is vital in the current economic 

climate, where demonstrating cost effectiveness is 

increasingly essential for the commissioning of services. 

Although, generally, there was strong agreement about the 

main reasons for conducting visits, there were clear differences 

in opinions regarding how visits should be conducted. 

Most respondents acknowledged the central role of home 

visit assessment in occupational therapy, but some therapists 

felt that other disciplines should be more actively involved. 

Opinions ranged from those therapists who believed that all 

patients should be given a visit which should be carried out by 

an occupational therapist, to those who cited clinical reasoning 

in each individual case and a consideration of the involvement 

of other professionals. This variation in perception regarding 

the role of home visits among professionals is the focus of 

ongoing research; some progress has been made in this area 

with regard to the perceptions of patients (Atwal et al 2012). 

Differences also existed in methods of transport and equipment 

taken. It was interesting to note that the most common 

items covered in the home visit bag related to health and safety 

considerations, rather than specifically to occupational therapy. 

Although this study represents the largest English survey 

of home visits after stroke, it is subject to a number of limitations. 

The response rate to the questionnaire was initially 

disappointing, but many occupational therapists made contact 

subsequently to say that they were too busy with paper 

work in their service to complete it. This may in itself be an 

important study observation. However, an overall response 

rate of 47% is acceptable (Oppenheim 2000) and the sample 

was from a wide geographical spread. It is unfortunate that 

the study had to be limited to England: occupational therapists 

from Scotland, Wales and Northern Ireland also made contact 

to say that they wished to participate in the research. It is clear 

from many of the additional comments that there are strong 

feelings about home visit practice, which may have influenced 

the findings: those who did not feel so strongly may 

have been those who were less inclined to respond. 

Conclusion 

This is the first study to collect data on the practice of home 

visits after stroke in England. The results highlight the diversity 

of practice and also the diversity of opinions regarding 

reasons for conducting visits. 

Acknowledgements 

■ We are grateful to the members of our steering committee (Professor 

Nadina Lincoln, Mr Oswald Newell, Dr Cecily Palmer, Dr Karen Stainer, 

Dr Kate Radford and Dr Nicola Brain). 

■ We are grateful to Associate Professor Natasha Lannin, Professor Lindy 

Clemson and Dr Annie McCluskey for giving us permission to adapt and 

use their original home visit survey instrument. 

■ We are grateful to all the occupational therapists who took the time to 

complete this questionnaire and for their support with the research. 

■ This paper presents independent research commissioned by the National 

Institute for Health Research (NIHR) as part of the Collaboration for Leadership 

in Applied Health Research and Care – Nottinghamshire, Derbyshire and 

Lincolnshire (CLAHRC-NDL). The views expressed are those of the authors 

and not necessarily those of the NHS, the NIHR or the Department of Health. 


401


Key findings 

■ There was large variation in visiting practice nationally. 

■ Average time for visit (including travel and report) was almost 4 hours. 

■ A significant proportion of this time was spent writing the report. 

What the study has added 

This research has provided valuable information on day-to-day home 

assessment visits. The next step is to use this to evaluate patient selection 

and examine the costs and effectiveness of visits. 

Conflict of interest: None declared. 

References 

Atwal A, Spiliotopoulou G, Plastow N, McIntyre A, McKay EA (2012) Older 

adults’ experiences of occupational therapy predischarge home visits: 

a systematic thematic synthesis of qualitative research. British Journal 

of Occupational Therapy, 75(3), 118-27. 

Barras S (2005) A systematic and critical review of the literature: the effectiveness 

of occupational therapy home assessment on a range of outcome 

measures. Australian Occupational Therapy Journal, 52(4), 326-36. 

College of Occupational Therapists (1990) Statement on home visiting with 

hospital in-patients. Standards, Policies and Proceedings 170. London: 

COT. 

Intercollegiate Stroke Working Party (2007) National Sentinel Stroke Audit. 

Clinical audit 2006. London: Royal College of Physicians. 

Intercollegiate Stroke Working Party (2011) National Sentinel Stroke Audit. 

Clinical audit 2010. London: Royal College of Physicians. 

Johnston K, Barras S, Grimer-Somers K (2010) Relationship between pre-discharge 

occupational therapy home assessment and prevalence of post-discharge 

falls. Journal of Evaluation in Clinical Practice, 16(6), 1333-39. 

Lannin N, Clemson L, McCluskey A (2011) Survey of current pre-discharge home 

visiting practices of occupational therapists. Australian Occupational Therapy 

Journal, 58(3), 172-77. 

Oppenheim AN (2000) Questionnaire design, interviewing and attitude 

measurement. London: Continuum International Publishing Group. 

Patterson C, Viner J, Saville C, Mulley G (2001) Too many pre-discharge home 

assessment visits for older patients? A postal questionnaire survey. Clinical 

Rehabilitation, 15(3), 291-95. 

Welch A, Lowes S (2005) Home assessment visits within the acute setting: 

a discussion and literature review. British Journal of Occupational Therapy, 

68(4), 158-64.

Occupational therapy predischarge home visits for patients with a ...

Create successful ePaper yourself

Delete template?

Save as template?