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Interdisciplinary interactions, social systems and technical infrastructure required for successful implementation of mobile stroke units : A qualitative process evaluation
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
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
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.
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.
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.
Keywords
ambulances, health services research, hospitals, implementation science, mixed methods research, mobile stroke unit, process evaluation, qualitative research, stroke
Date
2023
Type
Journal article
Journal
Journal of Evaluation in Clinical Practice
Book
Volume
29
Issue
3
Page Range
495-512
Article Number
ACU Department
Nursing Research Institute
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC-ND 4.0
File Access
Open
Notes
© 2023 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.