Evaluating the implementation of an early supported discharge (ESD) program for stroke survivors: A mixed methods...

Area of Science:

• Healthcare Management
• Implementation Science
• Stroke Rehabilitation

Background:

• Early Supported Discharge (ESD) models coordinate inpatient and community stroke care to reduce hospital stay.
• Limited understanding exists regarding the implementation of ESD into existing healthcare services.
• This study examines staff perceptions of implementing an ESD model in an Australian hospital.

Purpose of the Study:

• To describe staff perceptions of implementing an Early Supported Discharge (ESD) model for stroke survivors.
• To explore changes in these perceptions over the initial six months of implementation.

Main Methods:

• A mixed-methods case study design aligned with the Consolidated Framework for Implementation Research (CFIR).
• Data collected via surveys at three time points and focus groups.
• Participants included staff involved in referring, planning, implementing, or delivering ESD.

Main Results:

• Staff perceptions of ESD implementation changed over time, with diverse patterns across CFIR constructs.
• Individual and ESD characteristics received consistently positive perceptions.
• Patient needs and resources emerged as a key theme, with mixed perceptions regarding the inner setting but steady improvement in process perceptions.

Conclusions:

• The implementation of ESD involves complex interactions between CFIR domains.
• While generally positive and effective, the ESD implementation faced challenges and yielded unanticipated outcomes.
• The CFIR framework highlights the intricacies of knowledge translation in healthcare settings.