Patti Vanhook and Tracey Richmond explain a tool available to assist case managers to assure the survivor of strokes that they will receive the appropriate services to maximize recovery. They began in the recovery setting and sum up their discussion by reviewing Figure 1: screening tool for rehabilitation services. They explain that the case manager is in the pivotal role to facilitate appropriate discharge planning that meets both the needs of the stroke survivor and optimizes limited health resources. Next is the patient's postacute phase in Figure 2: postacute levels of care for stroke. The article ends with this all-inclusive statement; this stroke rehabilitation tool is designed to provide a guide in choosing appropriate services for each individual stroke patient.

Patty Nunez provides a series of strategies to overcome barriers to return to work for disabled individuals. She underwrites her article by saying when all else fails to communicate. Through frequent, clear, direct, and informative communication, painless return to work will result.

Sheila Bennion develops for the reader, "the how to overcome barriers to gain a successful return to work." She defines the common barriers to be aware of:

unavailable of modified duty work;

supervisor or employee discord;

lack of communication between provider,

employer and employee;

medical issues that preclude a safe return to work; and

psychosocial issues that impede or prevent the worker from reentering the work force.

She shares strategies to address and overcome each of these barriers. Her final guide line is: "Each injury brings different case dynamics and potential barriers." Remembering frequent and clear communication with each of the players develops the team to overcome barriers and achieve a successful return to work. The case manager has to be the quarterback to call correct signals.

Frances Snowden, BS, RN, CRRN, CCM, Contributing Editor