Mobilising evidence on stroke service organisation

Mobilising evidence on stroke service organisation: co-design, implementation, and evaluation of a knowledge mobilisation bundle

Stroke is a major cause of death and disability. People who have a stroke have the best chance of survival and recovery if they get the right care at the right time. Evidence suggests that delivery of stroke care and patient outcomes can be influenced by how stroke services are organised. Many individuals and organisations (including the National Clinical Director for Stroke, the Stroke Association, and several national programmes) take an active role in sharing this evidence with national policy makers, local services, patients and carers, and the general public. However, to date there has been limited progress in implementing major system change in hospital stroke services in England. In addition the processes by which research evidence comes to be reflected in clinical practice, and the factors that influence these processes, are as yet not well understood.

To address these important issues, this project aims to help to increase the use of evidence on stroke service organisation at national policy and local service levels, and improve our understanding of how evidence comes to be reflected in common healthcare practice. My project will address the following questions:

1.        What is currently done to help people use evidence about organisation of stroke services in national policy and local stroke services?

2.        In what ways can different approaches to sharing evidence help people make use of this evidence, and which factors influence this?

To investigate these questions, this project will carry out three main activities. First, current approaches to sharing evidence about organisation and delivery of stroke services will be analysed. This will involve observing people sharing evidence with different groups of people in a range of settings and interviews with people who are involved in sharing this evidence.

Second, ways to share evidence will be codesigned that are accessible to a wide range of people, including the general public, stroke patients and carers, clinicians and managers, commissioners, and politicians. Because people have different learning preferences, a ‘bundle’ of different approaches will be developed, which will include: traditional text briefings, infographics or cartoons, web-resources, workshops, and group discussions.

Finally, the bundle will be implemented and evaluated at national policy and local service levels, to understand how it works in practice. The evaluation will be based on stakeholder interviews, non-participant observations, and an anonymous online survey. The project will thus develop and evaluate new ways of sharing evidence, and provide important lessons on the processes of co-design, sharing of evidence, and evaluation of these activities.

Principal Investigator: Dr Angus Ramsay

Project Staff: Professor Naomi Fulop

Partners/Collaborators:

Professor Tony Rudd (Kings College London; NHS England)

Dr David Hargroves (East Kent Hospital University Foundation Trust; NHS Improvement/NHS England Getting It Right First Time for Stroke)

Alex Hoffman (Stroke Sentinel National Audit Programme)

Josh Edwards (The Stroke Association)

Judith Williamson (organisational development expert & patient representative)

Professor Mike Cooke (leadership and knowledge mobilisation)

Funder: NIHR Knowledge Mobilisation Research Fellowship Programme

Start Date: 2017

Duration: 3 years

Contact: angus.ramsay@ucl.ac.uk