Background: The quality of acute stroke care provided by allied health (AH) professionals remains sub-optimal despite evidence based recommendations to guide practice. The factors influencing care decisions are poorly understood.
Principal Investigators: Julie Luker, A/Prof Julie Bernhardt, Dr Ian Edwards, Prof Karen Grimmer-Somers
International centre for Allied Health Evidence, University of South Australia,
National Stroke Research Institute, part of Florey Neuroscience Intitutes, Melbourne.
Participating centres: Flinders Medical Centre (SA), The Queen Elizabeth Hospital (SA), Lyell McEwin Hospital (SA)
Aims: To better understand the care provided by AH professionals to patients with acute stroke, by (1) investigating associations between patient’s age, other demographic and stroke-related variables and quality of care, (2) exploring the clinical decision making of AH professionals.
Study Design: Mixed methods. Clinical quality audit and interviews with AH professionals.
Method: Clinical quality audit: Demographic, stroke and quality of care data were audited from the records of 300 acute stroke patients admitted to three tertiary hospitals in Adelaide SA. Quality of care was determined by the adherence of actual care to 20 evidence-based process indicators relevant to the work of AH professionals. Logistic regression analysis assessed relationships between predictor variables and quality of care.
Qualitative study: semi-structured interviews were conducted with 15 AH professionals working in acute stroke at the research sites. Data was analysed using a constructivist grounded theory approach to determine themes.
Quantitative & qualitative data were merged to strengthen the research conclusions.
Recruitment: Data collection was completed in July 2010
The following publications have arisen from this study:
Luker J, Wall K, Bernhardt J, Edwards I, Grimmer-Somers K. Patient’s age as a determinant of care received following an acute stroke: a systematic review. BMC Health Services Research. 2011; 161:1-10. http://www.biomedcentral.com/1472-6963/11/161
Luker J, Wall K, Edwards I, Bernhardt J, Grimmer-Somers K. Measuring the quality of dysphagia management practices following stroke: a systematic review. International Journal of Stroke. 2010; 5:466-476.
Luker J, Bernhardt J, Grimmer-Somers K. Demographic and stroke related factors as predictors of quality acute stroke care provided by allied health professionals. Journal of Multidisciplinary Healthcare. 2011; 4:247-259. http://dx.doi.org/10.2147/JMDH.S22569
Luker J, Bernhardt J, Grimmer-Somers K. Age and gender as predictors of allied health quality stroke care. Journal of Multidisciplinary Healthcare. 2011; 4:239-245. http://dx.doi.org/10.2147/JMDH.S21559
Luker J & Wall K. Swallow screening as an essential component of safe, quality acute stroke management. (Invited book chapter for Nova Science Publishers; accepted & in press Dec 2011)
Funding:
Australian Postgraduate Award (PhD scholarship)
“The human brain now holds the key to our future. We have to recall the image of the planet from outer space: a single entity in which air, water, and continents are interconnected. That is our home.”
