Development and implementation of the Ontario Stroke System: the use of evidence
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TLDR
This study provides guidance to support the development and implementation of evidence-based models of integrated service delivery across the continuum of care in the Ontario Stroke System.Abstract:
Introduction The Ontario Stroke System was developed to enhance the quality and continuity of stroke care provided across the care continuum. Research Objective To identify the role evidence played in the development and implementation of the Ontario Stroke System. Methods This study employed a qualitative case study design. In-depth interviews were conducted with six members of the Ontario Stroke System provincial steering committee. Nine focus groups were conducted with: Regional Program Managers, Regional Education Coordinators, and seven acute care teams. To supplement these findings interviews were conducted with eight individuals knowledgeable about national and international models of integrated service delivery. Results Our analyses identified six themes. The first four themes highlight the use of evidence to support the process of system development and implementation including: 1) informing system development; 2) mobilizing governmental support; 3) getting the system up and running; and 4) integrating services across the continuum of care. The final two themes describe the foundation required to support this process: 1) human capacity and 2) mechanisms to share evidence. Conclusion This study provides guidance to support the development and implementation of evidence-based models of integrated service delivery.read more
Citations
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Integrated care pathways
TL;DR: The system offers a set of guiding principles, based on the fact that, because knowledge and practice change continually when caring for patients, clinical records should be flexible and dynamic to accommodate these changes.
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Impracticability of Informed Consent in the Registry of the Canadian Stroke Network
Jack V. Tu,Donald J. Willison,Frank L. Silver,Jiming Fang,Janice A. Richards,Andreas Laupacis,Moira K. Kapral +6 more
TL;DR: Obtaining written informed consent for participation in a stroke registry led to important selection biases, such that registry patients were not representative of the typical patient with stroke at each center, and highlight the need for legislation on privacy and policies permitting waivers of informed Consent for minimal-risk observational research.
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Adherence to Postacute Rehabilitation Guidelines Is Associated With Functional Recovery in Stroke
Pamela W. Duncan,Ronnie D. Horner,Dean M. Reker,Gregory P. Samsa,Helen Hoenig,Byron B. Hamilton,Barbara J. LaClair,Tara K. Dudley +7 more
TL;DR: Greater levels of adherence to postacute stroke rehabilitation guidelines were associated with improved patient outcomes, and Compliance with guidelines may be viewed as a quality-of-care indicator with which to evaluate new organizational and funding changes involving postacUTE stroke rehabilitation.
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Advertising Strategies to Increase Public Knowledge of the Warning Signs of Stroke
TL;DR: In communities exposed to television advertising, ability to name the warning signs of stroke increased significantly and can be used to guide mass media–buying strategies for public health education.
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TL;DR: Canada needs to develop a publicly managed community-based system of primary care to provide integrated care for the frail elderly, which would have clinical and financial responsibility for the full range of health and social services required by this population.