• J Eval Clin Pract · Apr 2023

    Interdisciplinary interactions, social systems and technical infrastructure required for successful implementation of mobile stroke units: A qualitative process evaluation.

    • Kathleen L Bagot, Tara Purvis, Shaun Hancock, Henry Zhao, Skye Coote, Damien Easton, CampbellBruce C VBCVDepartment of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia.Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Austral, Steve M Davis, Geoff A Donnan, Shane Foster, Francesca Langenberg, Karen Smith, Michael Stephenson, Stephen Bernard, Sharon McGowan, Bernard Yan, Peter Mitchell, Sandy Middleton, and Dominique A Cadilhac.
    • Public Health and Health Services Research, Stroke, The Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Melbourne, Victoria, Australia.
    • J Eval Clin Pract. 2023 Apr 1; 29 (3): 495512495-512.

    RationaleMobile 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.AimTo identify successes and challenges in the pre- and initial operations of the first Australian MSU service from an interdisciplinary perspective.MethodsProcess 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.ResultsParticipants 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.ConclusionsSuccesses and challenges of establishing a new MSU service extend beyond technical, to include operational and social aspects across prehospital and hospital environments.© 2023 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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