Getting the message across; a realist study of the role of communication and information exchange processes in delivering stroke Early Supported Discharge services in England.

Autor: Chouliara N; School of Medicine, University of Nottingham, Nottingham, United Kingdom.; NIHR Applied Research Collaboration (ARC) East Midlands, Nottingham, United Kingdom., Cameron T; School of Medicine, University of Nottingham, Nottingham, United Kingdom., Byrne A; School of Medicine, University of Nottingham, Nottingham, United Kingdom.; School of Computer Science, University College Dublin, Dublin, Ireland., Fisher R; School of Medicine, University of Nottingham, Nottingham, United Kingdom.; Clinical Policy Unit, NHS England, Nottingham, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Mar 08; Vol. 19 (3), pp. e0298140. Date of Electronic Publication: 2024 Mar 08 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0298140
Abstrakt: Background: Stroke early supported discharge (ESD) involves the co-ordinated transfer of care from hospital to home. The quality of communication processes between professionals delivering ESD and external stakeholders may have a role to play in streamlining this process. We explored how communication and information exchange were achieved and influenced the hospital-to-home transition and the delivery quality of ESD, from healthcare professionals' perspectives.
Methods: Six ESD case study sites in England were purposively selected. Under a realist approach, we conducted interviews and focus groups with 117 staff members, including a cross-section of the multidisciplinary team, service managers and commissioners.
Results: Great variation was observed between services in the type of communication processes they employed and how organised these efforts were. Effective communication between ESD team members and external stakeholders was identified as a key mechanism driving the development of collaborative and trusting relationships and promoting coordinated care transitions. Cross-boundary working arrangements with inpatient services helped clarify the role and remit of ESD, contributing to timely hospital discharge and response from ESD teams. Staff perceived honest and individualised information provision as key to effectively prepare stroke survivors and families for care transitions and promote rehabilitation engagement. In designing and implementing ESD, early stakeholder involvement ensured the services' fit in the local pathway and laid the foundations for communication and partnership working going forward.
Conclusions: Findings highlighted the interdependency between services delivering ESD and local stroke care pathways. Maintaining good communication and engagement with key stakeholders may help achieve a streamlined hospital discharge process and timely delivery of ESD. ESD services should actively manage communication processes with external partners. A shared cross-service communication strategy to guide the provision of information along to continuum of stroke care is required. Findings may inform efforts towards the delivery of better coordinated stroke care pathways.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Chouliara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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