Facilitation strategies to improve the use of evidence in integrated stroke care

PURPOSE: Research evidence has identified practices across the care continuum which can improve the chronic condition of stroke; however, challenges remain to implementing this evidence. The two research projects presented evaluated whether facilitation can increase evidence-informed stroke care. THEORY: The Promoting Action on Research Implementation in Health Services framework was used to design and evaluate the facilitation strategies. METHODS: Project one evaluated the effect of a knowledge network, centralised around a knowledge broker, on increasing the awareness and application of evidence across the health care system. Project two used an interactive workshop to help family practitioners contextualise best practice recommendations for the secondary prevention of stroke. The research projects were conducted in primarily rural areas of Canada, and used mixed methods for evaluation. RESULTS AND CONCLUSIONS: The results indicate that the knowledge broker/network intervention effectively increased the awareness of evidence, and stimulated improvements in stroke care through increased communication networks. The workshop increased practitioner knowledge and support for health system changes necessary for integrated stroke care. The evaluation identified health-system barriers which affect implementation. DISCUSSION: These findings identify the need and methods for improving communication, which if implemented can reduce health system barriers to improving integrated stroke care.