Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact

Objectives: To explore the perspectives of healthcare professionals and commissioners working with a stroke Early Supported Discharge service in relation to: (1) the factors that facilitate or impede the implementation of the service, and (2) the impact of the service. Design: Cross-sectional qu...

Full description

Bibliographic Details
Main Authors: Chouliara, Niki, Fisher, Rebecca J., Kerr, Micky, Walker, Marion F.
Format: Article
Published: SAGE 2014
Subjects:
Online Access:https://eprints.nottingham.ac.uk/2813/
_version_ 1848790882334015488
author Chouliara, Niki
Fisher, Rebecca J.
Kerr, Micky
Walker, Marion F.
author_facet Chouliara, Niki
Fisher, Rebecca J.
Kerr, Micky
Walker, Marion F.
author_sort Chouliara, Niki
building Nottingham Research Data Repository
collection Online Access
description Objectives: To explore the perspectives of healthcare professionals and commissioners working with a stroke Early Supported Discharge service in relation to: (1) the factors that facilitate or impede the implementation of the service, and (2) the impact of the service. Design: Cross-sectional qualitative study using semi-structured interviews. Data were analysed by two researchers using a thematic analysis approach. Setting: Two Early Supported Discharge services in Nottinghamshire. Participants: Purposive sampling identified 35 key informants including practitioners, managers and commissioners. Results: The identified facilitators to the implementation of evidence-based services were: (1) the adaptability of the intervention to the healthcare context, (2) the role of rehabilitation assistants and (3) cross-service working arrangements. Perceived challenges included: (1) lack of clarity regarding the referral decision making process, (2) delays in securing social care input and (3) lack of appropriate follow-on services in the region. Most respondents perceived the impact of the services to be: (1) reducing in-hospital stay, (2) aiding the seamless transfer of care from hospital to the community and (3) providing intensive stroke specific therapy. Commissioners called for greater evidence of service impact and clarity regarding where it fits into the stroke pathway. Conclusions: Early Supported Discharge services were perceived as successful in providing home-based, stroke specific rehabilitation. Teams would benefit from capitalising on identified facilitators and developing strategies to address the challenges. The remit and impact of the services should be clear and demonstrable, with teams strengthening links with other health and social care providers.
first_indexed 2025-11-14T18:19:40Z
format Article
id nottingham-2813
institution University of Nottingham Malaysia Campus
institution_category Local University
last_indexed 2025-11-14T18:19:40Z
publishDate 2014
publisher SAGE
recordtype eprints
repository_type Digital Repository
spelling nottingham-28132020-05-04T20:14:49Z https://eprints.nottingham.ac.uk/2813/ Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact Chouliara, Niki Fisher, Rebecca J. Kerr, Micky Walker, Marion F. Objectives: To explore the perspectives of healthcare professionals and commissioners working with a stroke Early Supported Discharge service in relation to: (1) the factors that facilitate or impede the implementation of the service, and (2) the impact of the service. Design: Cross-sectional qualitative study using semi-structured interviews. Data were analysed by two researchers using a thematic analysis approach. Setting: Two Early Supported Discharge services in Nottinghamshire. Participants: Purposive sampling identified 35 key informants including practitioners, managers and commissioners. Results: The identified facilitators to the implementation of evidence-based services were: (1) the adaptability of the intervention to the healthcare context, (2) the role of rehabilitation assistants and (3) cross-service working arrangements. Perceived challenges included: (1) lack of clarity regarding the referral decision making process, (2) delays in securing social care input and (3) lack of appropriate follow-on services in the region. Most respondents perceived the impact of the services to be: (1) reducing in-hospital stay, (2) aiding the seamless transfer of care from hospital to the community and (3) providing intensive stroke specific therapy. Commissioners called for greater evidence of service impact and clarity regarding where it fits into the stroke pathway. Conclusions: Early Supported Discharge services were perceived as successful in providing home-based, stroke specific rehabilitation. Teams would benefit from capitalising on identified facilitators and developing strategies to address the challenges. The remit and impact of the services should be clear and demonstrable, with teams strengthening links with other health and social care providers. SAGE 2014-04 Article PeerReviewed Chouliara, Niki, Fisher, Rebecca J., Kerr, Micky and Walker, Marion F. (2014) Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact. Clinical Rehabilitation, 28 (4). pp. 370-377. ISSN 0269-2155 Stroke rehabilitation Early Supported Discharge Qualitative study Health services research Evidence-based practice http://cre.sagepub.com/content/28/4/370 doi:10.1177/0269215513502212 doi:10.1177/0269215513502212
spellingShingle Stroke rehabilitation
Early Supported Discharge
Qualitative study
Health services research
Evidence-based practice
Chouliara, Niki
Fisher, Rebecca J.
Kerr, Micky
Walker, Marion F.
Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact
title Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact
title_full Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact
title_fullStr Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact
title_full_unstemmed Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact
title_short Implementing evidence-based stroke Early Supported Discharge services: a qualitative study of challenges, facilitators and impact
title_sort implementing evidence-based stroke early supported discharge services: a qualitative study of challenges, facilitators and impact
topic Stroke rehabilitation
Early Supported Discharge
Qualitative study
Health services research
Evidence-based practice
url https://eprints.nottingham.ac.uk/2813/
https://eprints.nottingham.ac.uk/2813/
https://eprints.nottingham.ac.uk/2813/