Interdisciplinary interactions, social systems and technical infrastructure required for successful implementation of mobile stroke units: A qualitative process evaluation

Abstract

AbstractRationaleMobile stroke units (MSUs) are increasingly being implemented to provide acute stroke care in the prehospital environment, but a comprehensive implementation evaluation has not been undertaken.AimTo identify successes and challenges in the pre‐ and initial operations of the first Australian MSU service from an interdisciplinary perspective.MethodsProcess evaluation of the Melbourne MSU with a mixed‐methods design. Purposive sampling targeted key stakeholder groups. Online surveys (administered June–September 2019) and semistructured interviews (October–November 2019) explored experiences. Directed content analysis (raters' agreement 85%) and thematic analysis results are presented using the Interactive Sociotechnical Analysis framework.ResultsParticipants representing executive/program operations, MSU clinicians and hospital‐based clinicians completed 135 surveys and 38 interviews. Results converged, with major themes addressing successes and challenges: stakeholders, vehicle, knowledge, training/education, communication, work processes and working relationships.ConclusionsSuccesses and challenges of establishing a new MSU service extend beyond technical, to include operational and social aspects across prehospital and hospital environments.