학술논문
Interdisciplinary interactions, social systems and technical infrastructure required for successful implementation of mobile stroke units: A qualitative process evaluation.
Document Type
Article
Author
Bagot, Kathleen L.; Purvis, Tara; Hancock, Shaun; Zhao, Henry; Coote, Skye; Easton, Damien; Campbell, Bruce C. V.; Davis, Steve M.; Donnan, Geoff A.; Foster, Shane; Langenberg, Francesca; Smith, Karen; Stephenson, Michael; Bernard, Stephen; McGowan, Sharon; Yan, Bernard; Mitchell, Peter; Middleton, Sandy; Cadilhac, Dominique A.
Source
Subject
*STROKE treatment
*EVALUATION of medical care
*RESEARCH methodology
*MOBILE hospitals
*INTERVIEWING
*SURVEYS
*MEDICAL care research
*QUALITATIVE research
*HEALTH care teams
*EMERGENCY medical services
*RESEARCH funding
*DESCRIPTIVE statistics
*JUDGMENT sampling
*CONTENT analysis
*THEMATIC analysis
*EMERGENCY medicine
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Language
ISSN
1356-1294
Abstract
Rationale: Mobile stroke units (MSUs) are increasingly being implemented to provide acute stroke care in the prehospital environment, but a comprehensive implementation evaluation has not been undertaken. Aim: To identify successes and challenges in the pre‐ and initial operations of the first Australian MSU service from an interdisciplinary perspective. Methods: Process evaluation of the Melbourne MSU with a mixed‐methods design. Purposive sampling targeted key stakeholder groups. Online surveys (administered June–September 2019) and semistructured interviews (October–November 2019) explored experiences. Directed content analysis (raters' agreement 85%) and thematic analysis results are presented using the Interactive Sociotechnical Analysis framework. Results: Participants representing executive/program operations, MSU clinicians and hospital‐based clinicians completed 135 surveys and 38 interviews. Results converged, with major themes addressing successes and challenges: stakeholders, vehicle, knowledge, training/education, communication, work processes and working relationships. Conclusions: Successes and challenges of establishing a new MSU service extend beyond technical, to include operational and social aspects across prehospital and hospital environments. [ABSTRACT FROM AUTHOR]