There is strong evidence that early supported discharge and continued rehabilitation at home (ESD) delivered by an interdisciplinary team reduces deaths or dependency in activities in daily living after stroke. Despite recommendations in national guidelines ESD is only implemented in few places in Sweden. There are interdisciplinary teams that supply rehabilitation in the home but the coordinated transition is lacking. Such rehabilitation is not evidence based. The key components of a coordinated transition to achieve the benefits of ESD are not known. The aim is to design, implement and evaluate new person-centred transitions between stroke units and the home to achieve full ESD. The development of person-centred transition will be performed together by people with stroke, significant others, stroke unit staff and interdisciplinary teams.