Platform Presentation The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

Is it Feasible to Codesign Implementation Strategies with People with Lived Experience of Stroke to Improve Evidence-based Stroke Rehabilitation? (#28)

Elizabeth A Lynch 1 2 , Lemma Bulto 1 , Maria West 3 , Dominique Cadilhac 2 4 , Fawn Cooper 5 , Gillian Harvey 1
  1. Flinders University, Bedford Park, SA, Australia
  2. Florey Institute of Neuroscience and Mental Health, Melbourne
  3. Central Adelaide Local Health Network, Adelaide
  4. Monash University, Melbourne
  5. Lived Experience Contributor, Adelaide

Background

People with lived experience are rarely involved in implementation science research.

Aim

We designed this study to assess the feasibility of codesigning implementation strategies with people with lived experience of stroke and health professionals to improve evidence-based stroke rehabilitation.

Methods

Experience-Based CoDesign was used to codesign and deliver strategies over 6-months to implement 2 Stroke Clinical Guideline recommendations (information provision and amount of therapy) at one stroke rehabilitation unit.  Workgroups were formed with health professionals working on the unit and people with lived experience of stroke (survivors and carers) who had completed inpatient rehabilitation at the unit in the previous 6-12 months. Feasibility of the codesign process (focusing on acceptability, implementation fidelity, signal of promise) was evaluated using data from interviews, observations and inpatient self-reported outcomes before and after the implementation period.

Results

We invited 18 people with stroke to join the lived experience workgroup but only 8 (44%) agreed. All disciplines with ≥1 full-time staff members on the stroke unit were represented on the health professional workgroup. 

Median workgroup attendance over 6-months was n=8 health professionals, n=4 survivors of stroke, n=1 carers.  Workgroup members indicated that the project was enjoyable and facilitated effective partnerships between health professional and lived experience workgroup members.  Both cohorts reported contributing valuable input throughout the project, with responsibility shifting between groups at different project stages.  

The codesigned strategies signalled promise for improving aspects of information provision and creating additional opportunities for therapy. We could not compare patient-reported outcomes before and after the implementation period due to high variability between the pre-implementation and post-implementation patient cohorts.

Conclusion

It is feasible to codesign implementation strategies in inpatient rehabilitation with people with lived experience of stroke and health professionals. More research is required to determine the effect of the codesigned strategies on patient and service outcomes.