Abstract TP355: Supporting and Sustaining Systems Change Through the Development of Common Standards of Stroke Care

Background/Issues: The Stroke Flow initiative is a system-wide redesign of stroke services to enhance access to stroke best practices. Specifically, its focus is to ensure access to acute stroke units and timely and appropriate rehabilitation. To support this work, the Toronto Stroke Networks (TSNs) held forums with stroke nursing leaders (SNLs) within the Greater Toronto Area (GTA). Purpose: Through these forums, the purpose of this work was to develop evidenced-informed common standards of stroke care across the continuum and set priorities for implementation within the GTA. Methods: Six forums (from December 2011 to June 2012) were held for 43 SNLs from 16 acute and rehabilitation hospitals within the GTA. Using an appreciative inquiry approach, meetings focused on: 1) identifying common core elements (CCEs) for stroke care; 2) validating CCEs through consultation with interprofessional stroke teams; 3) forming consensus on CCEs; 4) identifying organizational priorities for implementation planning using thematic analysis; 5) integrating CCEs into existing processes of care; and 6) sustaining this work through the establishment of a stroke community of practice. Results: Through collaborative planning, CCEs were developed and reflect current and emerging best practices. Preliminary results from thematic analysis identified priorities related to: transitions of care, improved team communication processes, patient/family education, and integration of outcome measures across the care continuum. Conclusions: Common core elements of stroke care were collectively developed by the TSNs, stroke nursing leaders, and interprofessional teams to promote a standardization of stroke care that integrates best practices and identifies areas for improvement. Impact of this work has led to the development of CCE documents to support the integration and standardization of stroke care and the establishment of a stroke nursing community of practice. Final thematic analysis is currently underway to further identify priorities for implementation.