Recent reports describe current stroke healthcare delivery processes, including those related to rehabilitation, as suboptimal. The failure to consider the patient and family members as partners, and the lack of flow and continuity of information throughout the care continuum, contribute to inefficient service delivery. Ineffective interprofessional collaboration within the stroke units, as well as among services provided during patients' rehabilitation and community reintegration has been shown to impact service delivery.
Based on existing gaps in stroke service delivery, the first study of this proposed research program relies on a structured communication model, takes advantage of electronic information sharing tools among team members, as well as an interprofessional shared decision making model to lead the teams. A mixed methods design was chosen to evaluate the acceptability, feasibility and effectiveness of the proposed intervention. Participating professionals in stroke rehabilitation continuums in four locations will be guided through a systematic care delivery transformation that focuses on inter professional collaboration using theory-based, validated strategies.
The second study is an innovative intervention to provide rehabilitation treatments through remote, live consultations with a group of clinicians. Medical information will be made accessible via telecommunication technologies to all professionals involved in the rehabilitation process, including the patients' primary care providers. This quasi-experimental trial will evaluate the effectiveness and the implementation of this intervention within three sites, while providing strategies to improve interprofessional collaboration and services integration.
This research program will generate evidence on how teams involved in stroke rehabilitation care could develop their teamwork skills, and improve and adopt efficient modes of communication. In addition, it will rely on multiple strategies to facilitate change within teams and improve their capacity to collaborate and to integrate care within the stroke unit and at transition points, all the while reflecting best practice guidelines.