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Table 2 Facilitators to Implementation

From: Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial





Without the facilitator and the model, I don’t think we would have gotten as far as we did with the implementation of best practice.

Manager, Facilitated Site 4

One of the physiotherapists initially oriented the staff as to what it was about, and I’ve always thought of her as the go-to person for information.

Nurse, Passive Site 3

And what I tried to sort of make clear early on was that this, we were all in this project. Participation wasn’t an option so if either of the two sort of leaders of the project encountered any difficulties, be it with staff or lack of equipment, resources, anything like that, they were to let me know. Because if need be either [name] or I would have been the bad guy and stepped in. That never happened but they, I think they certainly felt that they weren’t out there on their own and we stressed at the beginning, it wasn’t their project, it was a [site name] project so they … We didn’t need to be the heavy but I think everyone understood that, you know, if need be we were there.

Manager, Facilitated Site 2

I think [name] took a leadership role in regards to the project itself.

Therapist, Passive Site 5

Agreement with the Intervention – Practical

Yes, we had our pocket cards, little laminated pocket cards, and those were quite useful. And also the posters in the rooms, for positioning, if you weren’t sure it was right there, so that was wonderful.

Nurse, Facilitated Site 2

The posters in the rooms were very helpful. The transfer and positioning posters were great to have above the beds, just to help make sure everything was done properly.

The digital frame was also very helpful

Nurse, Facilitated Site 6

Familiarity with the Recommended Treatments

We were doing the CMSA (Chedoke-McMaster Stroke Assessment) before so that wasn’t new...

We were already doing some of the upper extremity tasks…

Therapist, Passive Site 4

From the recommendations, a lot of the stuff we were already doing. Things like aerobic conditioning, I found like the implementations reinforced that that was a good thing we were doing.

Manager, Passive Site 3

Team Communication and Interdisciplinary Collaboration

We have good relationships. Certainly it is a good relationship but I think it only got better when we did this particular education piece of it or how we particularly did it. Because I think we gave each of the groups a little more respect for the other group in terms of what they do. Because, you know, a lot of nurses really don’t know what OTs actually do because O therapy is a little more objective in terms of working with muscle groups and joints and things like this. But with OT, you know, they sort of take the patients off to the bathroom or up to their work area or whatever and they just don’t know a heck of a lot of what they do. But with this little educational piece that we did, they learned.

Nurse, Passive Site 1

I think generally, among the physios, we tend to talk to each other a fair bit. And even among the OTs and the other team, if there’s issues, we’re talking. If not on a daily basis, then at least every 2 or 3 days. Definitely in rounds. Sort of even informally consulting in the corridors with stuff like that about various patients.

Therapist, Passive Site 1

…we established early, early on was a committee, sort of a joint therapist, nursing staff, healthcare aid committee. So as we were moving forward communication happened within that committee.

Manager, Passive Site 2

Team Communication and Interdisciplinary Collaboration

The workshop was very good at explaining the “why” behind the treatment modalities, and I think that was helpful. That was more helpful than just a list of recommendations, because having a rationale and a justification for why a treatment is the best choice was useful.

Therapist, Passive Site 3

Yes. From an interdisciplinary standpoint, PT and OT have a mixed office now. The stroke unit has an office now as well. There has been more collaboration and team work. The staff that has signed up to work on the dedicated stroke unit are working on the dedicated stroke unit. They interact more, and there is more collaboration

Manager, Facilitated Site 4

And I think you’re also encouraging each other with it because now that you’ve gone through the education and been part of this project…

Nurse, Passive Site 1