Development of a network of sites and ‘up-skilled’ therapists to deliver best-practice stroke rehabilitation of the upper limb
One-in-four adults suffer a stroke, adding $5 billion per year to Australia’s healthcare costs. Stroke is a leading cause of chronic adult disability, yet many Australian survivors have long-term unmet needs. One-in-2 survivors lose the sense of touch. ‘It is like the hand is blind’. Many learn not to use their hand, restricting return to valued activities and work. A top-ten priority for survivors that impacts life after stroke is ‘best treatment for arm recovery’.
We formed a Partnership of clinicians, health providers, consumers, researchers and academics, with the aim to increase access to best-practice stroke rehabilitation of the arm and thus achieve better outcomes for stroke survivors. Our Partnership approach is core to achieving our aim and embedding changes. In 2014 we partnered with eight healthcare networks to improve implementation in existing clinical practice settings. This Sense Implement collaboration evolved as a direct response to requests from clinician peers and partner organisations to up-skill therapists in an area of clinical practice (previously neglected) that they lacked confidence and skills. In 2017, with the support of an NHMRC Partnership grant (known as Sense CONNECT), we expanded our collaborative partnership to create a centralised knowledge-translation hub and four specialist therapy centres, extending our work with healthcare networks. The hub and specialist centres are founded on strong partnerships between healthcare networks, research institutes and universities.
Our model is working to increase access through:
- education and upskilling of therapists;
- provision of specialist community services to complement existing services;
- embedding a community of up-skilled therapists in health care settings; and
- creation of a structure to support and sustain change.
We also aim to develop an implementation template to guide future translational activities.
Figure: Diagram of the centralised translation hub and delivery modes; with champion therapists at existing healthcare settings and specialist therapy centres. Each interact with and are supported by the central hub.
People and organisations involved
The core team comprises a multidisciplinary group of experts in implementation science, stroke rehabilitation and service delivery:
- Prof Leeanne Carey, La Trobe University and Florey Institute of Neuroscience and Mental Health: Occupational therapist, rehabilitation, neuroscience, implementation science.
- Prof Michael Nilsson, University of Newcastle: Rehabilitation physician, knowledge translation leader.
- Prof Vincent Thijs, Austin Health and Florey Institute of Neuroscience and Mental Health: Stroke neurologist, neuroscience, stroke services.
- Prof Natasha Lannin, Monash University and Alfred Health: Occupational therapist, NHMRC Translating Research into Practice fellow.
- Prof Susan Hillier, UniSA Health: Physiotherapist, rehabilitation, guideline development.
- Prof Dominique Cadilhac, Florey Institute of Neuroscience and Mental Health and Monash University: Nurse, health economist, head Translational Public Health Unit, Australian Stroke Clinical Registry.
- Prof Geoffrey Donnan, University of Melbourne: Neurologist, stroke management.
- Prof Meg Morris, La Trobe University and Healthscope: Clinical and Rehabilitation practice.
- Prof Leonid Churilov, University of Melbourne: Statistics and Decision Analysis Academic platform.
- Prof Marion Walker, University of Nottingham, Stroke Rehabilitation, implementation, UK.
Collaborators and Partner leads/organisations
- Prof Geoffrey Cloud, Alfred Health (metro public)
- Prof Michael Pollack, Hunter New England Health (interstate, metro)
- Prof Esther May, UniSA Health (interstate private)
- Prof Vincent Thijs and Michael Murray, Austin Health (metro public)
- Prof John Olver, Epworth Health (metro private)
- Prof Marc Budge, Bendigo Health (rural public)
- Prof Tissa Wijeratne, Western Health (metro public)
- Dr Toni Hogg, Barwon Health (regional public)
- Fiona mcKinnon, St Vincent’s Hospital (metro public)
- Sharon McGowan, National Stroke Foundation, consumer advocate
Find out more about the project at the Australian New Zealand Clinical Trials Registry website. Trial Registration: ACTRN12618001389291. Title: Network of sites and ‘up-skilled’ therapists to deliver best-practice stroke rehabilitation of the upper limb.