Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive study
Background Older adults with stroke and multimorbidity experience frequent care transitions, which are often poorly coordinated and fragmented. We conducted a pragmatic randomized controlled trial (RCT) to test the implementation and effectiveness of the Transitional Care Stroke Intervention (TCSI),...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-02-01
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| Series: | Journal of Multimorbidity and Comorbidity |
| Online Access: | https://doi.org/10.1177/26335565251323748 |
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| author | Maureen Markle-Reid Kathryn Fisher Kimberly M. Walker Jill I. Cameron David Dayler Rebecca Fleck Amiram Gafni Rebecca Ganann Ken Hajas Barbara Koetsier Robert Mahony Chris Pollard Jim Prescott Tammy Rooke Carly Whitmore |
| author_facet | Maureen Markle-Reid Kathryn Fisher Kimberly M. Walker Jill I. Cameron David Dayler Rebecca Fleck Amiram Gafni Rebecca Ganann Ken Hajas Barbara Koetsier Robert Mahony Chris Pollard Jim Prescott Tammy Rooke Carly Whitmore |
| author_sort | Maureen Markle-Reid |
| collection | DOAJ |
| description | Background Older adults with stroke and multimorbidity experience frequent care transitions, which are often poorly coordinated and fragmented. We conducted a pragmatic randomized controlled trial (RCT) to test the implementation and effectiveness of the Transitional Care Stroke Intervention (TCSI), a 6-month, multi-component, evidence-informed intervention to support older adults with stroke and multimorbidity using outpatient stroke rehabilitation services. The TCSI was designed to support self-management, improve health outcomes, and enhance the quality and experience of care transitions. Objective To explore the facilitators and challenges to implementing the TCSI, from the perspective of healthcare providers (HCPs) (n = 12) and Managers (n = 3). Methods Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Data were collected from study documents, individual and group interviews conducted with HCPs and a Care Coordinator, and surveys from managers. Data were analyzed using thematic analysis. Results Intervention implementation was facilitated by: a) strong collaborative and interdependent HCP team relationships, b) dedicated resources (funding, staffing) to support intervention delivery, c) training and ongoing support, customized to individual HCP needs, d) organizational readiness, strong leadership, and effective champions, e) structures to facilitate virtual information-sharing, and f) regular monitoring of intervention implementation. Implementation challenges included: a) COVID-19 related challenges (staff turnover, community service disruptions), b) poor communication with community service providers, c) documentation burden (intervention-related), and d) virtual care delivery. Conclusions This research enhances understanding of the diversity of factors influencing implementation of the TCSI, and the conditions under which implementation is more likely to succeed. |
| format | Article |
| id | doaj-art-448761f63b7d47bb9f74d6f113fb4113 |
| institution | DOAJ |
| issn | 2633-5565 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Multimorbidity and Comorbidity |
| spelling | doaj-art-448761f63b7d47bb9f74d6f113fb41132025-08-20T03:04:55ZengSAGE PublishingJournal of Multimorbidity and Comorbidity2633-55652025-02-011510.1177/26335565251323748Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive studyMaureen Markle-ReidKathryn FisherKimberly M. WalkerJill I. CameronDavid DaylerRebecca FleckAmiram GafniRebecca GanannKen HajasBarbara KoetsierRobert MahonyChris PollardJim PrescottTammy RookeCarly WhitmoreBackground Older adults with stroke and multimorbidity experience frequent care transitions, which are often poorly coordinated and fragmented. We conducted a pragmatic randomized controlled trial (RCT) to test the implementation and effectiveness of the Transitional Care Stroke Intervention (TCSI), a 6-month, multi-component, evidence-informed intervention to support older adults with stroke and multimorbidity using outpatient stroke rehabilitation services. The TCSI was designed to support self-management, improve health outcomes, and enhance the quality and experience of care transitions. Objective To explore the facilitators and challenges to implementing the TCSI, from the perspective of healthcare providers (HCPs) (n = 12) and Managers (n = 3). Methods Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Data were collected from study documents, individual and group interviews conducted with HCPs and a Care Coordinator, and surveys from managers. Data were analyzed using thematic analysis. Results Intervention implementation was facilitated by: a) strong collaborative and interdependent HCP team relationships, b) dedicated resources (funding, staffing) to support intervention delivery, c) training and ongoing support, customized to individual HCP needs, d) organizational readiness, strong leadership, and effective champions, e) structures to facilitate virtual information-sharing, and f) regular monitoring of intervention implementation. Implementation challenges included: a) COVID-19 related challenges (staff turnover, community service disruptions), b) poor communication with community service providers, c) documentation burden (intervention-related), and d) virtual care delivery. Conclusions This research enhances understanding of the diversity of factors influencing implementation of the TCSI, and the conditions under which implementation is more likely to succeed.https://doi.org/10.1177/26335565251323748 |
| spellingShingle | Maureen Markle-Reid Kathryn Fisher Kimberly M. Walker Jill I. Cameron David Dayler Rebecca Fleck Amiram Gafni Rebecca Ganann Ken Hajas Barbara Koetsier Robert Mahony Chris Pollard Jim Prescott Tammy Rooke Carly Whitmore Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive study Journal of Multimorbidity and Comorbidity |
| title | Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive study |
| title_full | Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive study |
| title_fullStr | Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive study |
| title_full_unstemmed | Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive study |
| title_short | Implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity: A qualitative descriptive study |
| title_sort | implementation of the virtual transitional care stroke intervention for older adults with stroke and multimorbidity a qualitative descriptive study |
| url | https://doi.org/10.1177/26335565251323748 |
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