The importance of normative integration in stroke services: case study evidence from Sweden and England

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Abstract

Objectives: A number of evidence based interventions are now available for stroke patients. Good quality stroke care involves a range of health professionals located across ambulance, hospital, community and primary care services. This study examined the perspectives of healthcare workers involved in stroke care in Sweden and England on the integration challenges stroke care presents.

Methods: Four qualitative case studies were carried out in Sweden and England, including 95 semi-structured interviews with clinicians and managers associated with four different hospitals providing specialised stroke services.

Findings: High levels of organisational, functional, service and clinical integration amongst clinicians that deliver emergency and acute stroke care were identified. This is frequently lacking amongst professionals delivering post-acute care. These findings are linked to the prevalence or lack of normative and systemic integration in each respective stage of care.

Conclusions: Emphasis on the need to treat stroke as an emergency condition in both countries has created a context in which normative and systemic integration often occurs amongst clinicians that deliver emergency and acute stroke care, aiding the development of organisational, functional, service and clinical integration across the case study sites. In contrast, integration between hospital and community (rehabilitation and general practice) care is frequently less successful.
Original languageEnglish
Pages (from-to)155-161
Number of pages7
JournalHEALTH SERVICES MANAGEMENT RESEARCH
Volume25
Issue number4
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Stroke care; Integration; Stroke units; Sweden; England; Qualitative research.

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