Related Experiment Video
Updated: Jul 26, 2025
09:52
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
17.2K
Temporal structures that determine consistency and quality of care: a case study in hyperacute stroke services
Georgia B Black1,2, Angus I G Ramsay3, Robert Simister4
1Applied Health Research, University College London, London, UK g.black@ucl.ac.uk.
BMJ Quality & Safety
|June 19, 2023
Summary
Temporal structuring in hyperacute stroke wards impacts care quality. Improving consistency requires changes to service design, staffing, and social norms, especially regarding weekend work.
Area of Science:
- Healthcare Management
- Quality Improvement
- Stroke Care
Background:
- Temporal structuring, influenced by practices and social norms, significantly affects healthcare quality and timing.
- Hyperacute stroke wards, critical for initial stroke care, were studied to understand temporal structuring's impact on quality.
Purpose of the Study:
- To explore temporal structuring patterns within hyperacute stroke wards.
- To explain how these patterns influence the quality of stroke care.
Main Methods:
- Thematic analysis of qualitative interviews with 76 hyperacute stroke staff members.
- Non-participant observations (41 sessions, ~102 hours) and documentary analysis of service standards guidance.
- Inductive coding was used to identify thematic findings related to temporal structuring.
Main Results:
- Clinical priorities and metrics drive rapid initial interventions.
- Ward organization (rotas, ward rounds) and social norms (especially weekend work) impact care consistency and quality.
- Bottlenecks and backlogs resulting from temporal structures hinder effective service improvement.
Conclusions:
- Temporal consistency in high-quality patient care is essential.
- Service design (staffing, pathways) and cultural attitudes towards work patterns are key to temporal consistency.
- Improvements necessitate changes to structural elements like rotas and ward rounds, alongside addressing social norms around weekend work.
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
13
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
13
01:29Documentation in Long-Term and Home Healthcare Setting
932
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
932
01:26Aneurysm III: Interprofessional Care
12
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
12
01:20Acute Kidney Injury V: Interprofessional Care
30
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
30