Journal article

Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (T-3 trial): a qualitative study

Elizabeth McInnes, Simeon Dale, Louise Craig, Rosemary Phillips, Oyebola Fasugba, Verena Schadewaldt, N Wah Cheung, Dominique A Cadilhac, Jeremy M Grimshaw, Chris Levi, Julie Considine, Patrick McElduff, Richard Gerraty, Mark Fitzgerald, Jeanette Ward, Catherine D'Este, Sandy Middleton

Implementation Science | BMC | Published : 2020

Abstract

BACKGROUND: The implementation of evidence-based protocols for stroke management in the emergency department (ED) for the appropriate triage, administration of tissue plasminogen activator to eligible patients, management of fever, hyperglycaemia and swallowing, and prompt transfer to a stroke unit were evaluated in an Australian cluster-randomised trial (T3 trial) conducted at 26 emergency departments. There was no reduction in 90-day death or dependency nor improved processes of ED care. We conducted an a priori planned process influential factors that impacted upon protocol uptake. METHODS: Qualitative face-to-face interviews were conducted with purposively selected ED and stroke clinicia..

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Grants

Awarded by NHMRC Project Grant


Awarded by NHMRC


Funding Acknowledgements

The T3 Trial was funded by a NHMRC Project Grant 1024812 (2012-2017). The following authors received research fellowship funding from the NHMRC: Dominique Cadilhac (co-funded with Heart Foundation: 1063761 and 1154273) and Chris Levi (Practitioner: 1043913). Jeremy Grimshaw holds a Canada Research Chair in Health Knowledge Transfer and Uptake. Non-material support provided by the trial sponsor, Australian Catholic University, to house members of the trial team including authors SM, SD, EM, RP, OF, VS and LC.