4.6 Article

Reimagining Stroke Rehabilitation and Recovery Across the Care Continuum: Results From a Design-Thinking Workshop to Identify Challenges and Propose Solutions

期刊

出版社

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2021.01.074

关键词

Delivery of health care; Education; Neurological rehabilitation; Stroke; Rehabilitation

资金

  1. American Heart Association/American Stroke Association Northeast Cerebrovascular Consortium pilot grant
  2. Massachusetts General Hospital Center for Neurotechnology and Neurorecovery

向作者/读者索取更多资源

This study conducted a multidisciplinary interactive workshop to identify major challenges facing stroke recovery and proposed unique solutions, including new technologies, healthcare system changes, and the creation of new support roles. Analysis revealed that a comprehensive stroke clinic with follow-up programs, cutting edge treatments, patient advocation, and research was the single proposed solution that solved the most identified challenges.
Systems for stroke rehabilitation and recovery are variable and fragmented; stroke survivors often experience gaps in care with detrimental effects on their recovery. We designed and hosted a multidisciplinary and interactive workshop to discuss challenges facing patients recovering from stroke and to brainstorm solutions. Forty-one participants including clinicians, researchers, and stroke survivors attended the workshop. Participants were surveyed beforehand about challenges facing stroke recovery and results were tabulated as a word cloud. An interactive, design-thinking exercise was conducted that involved completing workbooks, hands-on prototype designing, and presentations, which were then analyzed through qualitative content analysis using an inductive approach. High frequency words in the word cloud of survey responses included access, fragmented, and uncertainty. Qualitative analysis revealed 6 major challenge themes including poor (1) transitions in and (2) access to care; (3) barriers to health insurance; (4) lack of patient support; (5) knowledge gaps; and (6) lack of standardized outcomes. Eleven unique solutions were proposed that centered around new technologies, health care system changes, and the creation of new support roles. Analysis of the alignment between the challenges and solutions revealed that the single proposed solution that solved the most identified challenges was a comprehensive stroke clinic with follow-up programs, cutting edge treatments, patient advocation and research. Through our interactive design-thinking workshop process and inductive thematic analysis, we identified major challenges facing patients recovering from stroke, collaboratively proposed solutions, and analyzed their alignment. This process offers an innovative approach to reaching consensus among interdisciplinary stakeholders. Archives of Physical Medicine and Rehabilitation 2021;102:1645-57 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine

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