This was the exact philosophy behind the work of University of Tasmania researcher Dr Sarah Prior when faced with the gravity of the difficulties in caring for stroke patients in rural areas such as in Tasmania’s North West.
"Rural Australia faces unique challenges when it comes to health care, including stroke service," Dr Prior said.
“For a start it is not always possible in rural Australia to have a full stroke unit available, despite the fact we know that there are better clinical outcomes when stroke care is delivered in a dedicated stroke unit. “
A researcher with the Tasmanian School of Medicine’s Healthcare Redesign Program, Dr Prior led a team in 2017 to redesign acute stroke services in North West Tasmania utilising ‘co-design,’ which at its core involves engaging patients, their families and a range of staff involved in caring for stroke patients.
The project was aimed at gaining a better understanding of the issues in respect to stroke services and care and to design and deliver improved health services.
The ‘team’ included 27 patients (and their families/carers) from across the North West and 27 staff members including nursing staff, medical consultants and registrars, physiotherapists, occupational therapists, speech pathologists, social workers, clinical nurse educators, GP’s, pharmacists and radiologists.
The 12-month project resulted in many recommendations, some of which were immediately implemented with obvious results.
The North West now has a full-time clinical nurse consultant for stroke service, Interdisciplinary information forums and information sessions available for medical staff, a suite of documents to assist with equitable state-wide management of hyper acute stroke care, follow up phone calls to discharged stroke and Transient Ischemic Attack (mini-stroke) patients to discuss their stroke care, education and risk factors and a 24-hour telemedicine neurology service being launched to enable thrombolysis (a treatment to dissolve dangerous clots in blood vessels). The implementation of further recommendations is also ongoing.
Dr Prior said the research, which was a first for Tasmania, provided an important precedent for broader rural health care everywhere.
By understanding the patient experience, we can more effectively deliver on patient’s needs, including decisions about their care and treatment, diagnosis, screening and medication. It helps to identify strengths and weaknesses in the health system and develop patient-centred solutions.
Dr Prior is also working on innovative research in the North
West with a team led by University of Tasmania Professor of Clinical
Redesign-Nursing Professor Steve Campbell and Doug Doherty at Family Based
Care, Burnie focused on ‘reablement.’
A relatively new approach to healthcare, reablement has an emphasis on interdisciplinary rehabilitation for people who are at risk of functional decline, to keep them as independent for as long as possible.
This project encompasses the needs of clients in aged care, those living with dementia and disability (including injury) – ranging in age from children to the elderly.
Outcomes of this research have included the development of a pre-employment questionnaire which focuses on a ‘readiness for reablement’ in community care organisations and the introduction of a reablement-based care approach at Family Based Care in Burnie through co-designed education and evaluation. Staff and client participation in this study means that the system is more closely aligned with the needs of those who are a part it and use it.
“Reablement can make a significant difference through greater improvement in self-care, home management, and mobility as well as improved participation in society,” Dr Prior said.
“In a client’s home, it enables independence and autonomy and the support clients receive from reablement increases their confidence to safely perform and participate in everyday and social activities.”
“Essentially, we want people to maintain as much independence for as long as possible – ‘Doing with, rather than doing for.’
The Tasmanian School of Medicine is part of the University’s College of Health and Medicine.