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Title: Interdisciplinary interactions, social systems and technical infrastructure required for successful implementation of mobile stroke units: A qualitative process evaluation.
Austin Authors: 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
Affiliation: The Florey Institute of Neuroscience and Mental Health
Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
Public Health and Health Services Research, Stroke, Heidelberg, University of Melbourne, Melbourne, Victoria, Australia.
Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Ambulance Victoria, Melbourne, Victoria, Australia.
Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Stroke Foundation, Melbourne, Victoria, Australia.
Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Issue Date: Apr-2023 2023
Publication information: Journal of Evaluation in Clinical Practice 2023; 29(3)
Abstract: 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. To identify successes and challenges in the pre- and initial operations of the first Australian MSU service from an interdisciplinary perspective. 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. 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. Successes and challenges of establishing a new MSU service extend beyond technical, to include operational and social aspects across prehospital and hospital environments.
DOI: 10.1111/jep.13803
ORCID: 0000-0003-2895-4327
Journal: Journal of Evaluation in Clinical Practice
Start page: 495
End page: 512
PubMed URL: 36648226
ISSN: 1365-2753
Type: Journal Article
Subjects: ambulances
health services research
implementation science
mixed methods research
mobile stroke unit
process evaluation
qualitative research
Appears in Collections:Journal articles

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