Evaluating the impact of a training program to support transitioning from the hospital to the community for people after stroke: a community case study

BMC Health Services Research

Michelle Lui¹  Janice J. Eng²  Marie-Louise Bird³  Katherine McKellar⁴  Shari Cooper⁵ 

[1] Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, 2211 Wesbrook Mall T325, V6T 2B5, Vancouver, BC, Canada;Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212-2177 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada;Rehabilitation Research Program, GF Strong Rehabilitation Research Laboratory, Vancouver Coastal Health Research Institute, 4255 Laurel Street, V5Z 2G9, Vancouver, BC, Canada;Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212-2177 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada;Rehabilitation Research Program, GF Strong Rehabilitation Research Laboratory, Vancouver Coastal Health Research Institute, 4255 Laurel Street, V5Z 2G9, Vancouver, BC, Canada;School of Health Sciences, University of Tasmania, Newnham Drive, 7250, Launceston, Tasmania, Australia;Kelowna General Hospital, 2268 Pandosy Street, V1Y 1T2, Kelowna, BC, Canada;Parkinson’s Recreation Centre, 1800 Parkinsons way, V17 4P9, Kelowna, Canada;

关键词: Stroke rehabilitation;    Transitions;    Community navigation;    Physiotherapy;    Exercise;    Implementation science;   

DOI  :  10.1186/s12913-021-07436-7

来源: Springer

【 摘 要 】

BackgroundThe transitions in care along the stroke recovery path are challenging, particularly in finding mechanisms to continue one’s recovery once at home. We aim to evaluate the impact of training physiotherapists and fitness instructors from one regional community together to deliver an evidence-based group exercise program starting in the hospital and transitioning to the community using an implementation approach.MethodsThe evidenced based exercise program Fitness and Mobility Exercise (FAME) for stroke was chosen as the intervention. Data from interviews with stakeholders (community centre and health authority hospital staff including a physiotherapy navigator) was transcribed and themes evaluated using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. These data were supplemented by information collected as a quality assurance project within the health authority.ResultsTwo programs were established; one in the community centre (run over 15 months by fitness instructors) and one in the regional hospital (run over 12 months by a rehabilitation assistant under the direction from a physiotherapist). Transitions in care were facilitated by implementing the same evidence-based group exercise class in both the hospital and community setting, so people living with stroke could seamlessly move from one to another. An existing physiotherapist navigator service also was valued as a support for the transitions between the two centres for people with stroke. The hospital group accessed group-based physiotherapy service on average 31 days earlier than they were able to in a one-to-one format.ConclusionsThis case study described the implementation of the Fitness and Mobility Exercise (FAME) program in one community and the use of a physiotherapist navigator to assist transition between them. After a community training workshop, FAME programs were established within the health authority and the community centre. FAME program participants within the health authority benefited from reduced wait times to access hospital outpatient physiotherapy service. Improvements in function were measured in and reported by the people after stroke attending either the health authority or community centre FAME groups.

【 授权许可】

CC BY