National Service Framework for Older People: stroke coordinators

Abstract

The National Service Framework (NSF) for Older People aims to develop integrated stroke services with specialized treatment, carer involvement, secondary prevention and rehabilitation. There is an emphasis upon the role of stroke coordinators. The aim of this study was to examine the relationships between stroke coordinators and other agencies involved in stroke care, and to describe stroke coordinators' current roles. Interviews with 11 stroke coordinators across the West Midlands region took place and were evaluated using a grounded theory approach. The roles of stroke coordinators and the perceived levels of integration among stroke services varied between localities. In a few areas, a number of 'adhesive' factors helped bond the coordinator role to successful integration, while in most areas the absence of all or some of these factors made the role less effective. To meet the demands of the NSF, a stroke coordinator's role needs to be a high profile, corporate function, requiring a higher level of autonomy, accountability and responsibility, and demanding creativity and innovation from post holders.

Influence of stroke coordinators on delivery of acute stroke care and hospital outcomes: An observational study

“…Many dimensions to the SC role have been reported, including clinical activities such as development of care pathways and systems of care, educational activities for patients, carers and other health professionals, management and leadership, and audit and research. 8,12,19,20 As a result of the marked role diversity internationally, it is difficult to generalize these results to other countries. While the organizational survey data provide some information on the diverse roles, directly measuring the effects of some of these roles through audit alone is difficult.…”

“…5 Recommendations from numerous national and international stroke guidelines endorse the coordinator role within the acute and subacute setting. [6][7][8] The SC position may also be referred to as stroke liaison officer, stroke facilitator, or clinical coordinator.…”

“…9,10 However, common components include educating other interdisciplinary staff and patients, the ability to provide clinical leadership, and involvement in establishing and implementing protocols to ensure standardized evidence-based care. 8,11 Other dimensions reported include administrative, quality monitoring (e.g. audit or research), and managerial/budget responsibilities.…”

“…audit or research), and managerial/budget responsibilities. 8 To our knowledge, there is limited evidence from randomized clinical trials that SCs directly improve patient outcomes post stroke. There is indirect evidence that this role is important to improve the organization of stroke services, provide evidence-based stroke care, and influence discharge destination.…”