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Research team

Modelling the impact of service innovation in stroke care Information and Communication Research Initiative 2 (ICTRI 2) Research Seminar 15 February 2007. Core team Dr Baggy Cox (Project Leader) Prof. James Barlow (telecare) Dr Christina Petsoulas (qualitative research)

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Research team

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  1. Modelling the impact of service innovation in stroke careInformation and Communication Research Initiative 2 (ICTRI 2) Research Seminar15 February 2007

  2. Core team Dr Baggy Cox (Project Leader) Prof. James Barlow (telecare) Dr Christina Petsoulas (qualitative research) Dr Steffen Bayer (modelling) Specialist team Dr Stephen Morris (Brunel, cost analysis) Dr Martin Fisher (King’s Fund, dissemination Dr Alasdair Honeyman (care processes / policy) Research team

  3. Project aims • To map out the care journey for stroke patients • To identify components in the care journey which could potentially be improved • To identify appropriate interventions (ICT or others) that might improve stroke care delivery in line with new policy guidelines • Support local care community with planning stroke services (Greenwich SHA, Queen Elizabeth Hospital Trust)

  4. Policy relevance • NSF for Older People, standard 5 (2001) • National Audit Office, Reducing Brain Damage. Faster Access to Better Stroke Care (2005) • National Stroke Strategy (2006-07) • NSF Long-term (neurological) conditions (2005) • The NHS and Social Care long-term conditions model • Our Health, Our Care, Our Say (2006) • Telecare programme (PTG, Whole System Demonstrators etc.)

  5. Methods • Literature searches – technology and service delivery innovation for stroke care • Map of Medicine – understanding stroke care pathways • Interviews with key stakeholders within the local care system (acute, primary, social) • Interactive workshops with key stakeholders (data collection for simulation modelling) • Simulation modelling and cost analysis of alternative delivery models

  6. System dynamics modelling • Using simulation modelling to study actual and potential care delivery processes • System dynamics can help to explore • Capacity requirements and bottlenecks • Distribution of resource demands across the care system • Intended & unintended consequences of ICT implementation and service change

  7. Example: telecare and demand for institutional care

  8. Timetable

  9. Progress: Dec. 2006 – Feb. 2007 • Literature searches on optimisation of stroke care provision (including telecare) • Initial interviews with local stakeholders • Formulated preliminary picture of local stroke care delivery (current practice and future directions)

  10. Current local picture • Capacity pressures in the acute hospital • Prompt CT scanning • Lack of thrombolysis facilities • Hospital rehabilitation • Capacity pressures in the community • Workforce availability • Discharge coordination • Equipment provision

  11. Potential improvements identified in stroke literature • Better and more efficient stroke treatment is achieved in ‘stroke care systems’ • integrated services involving close communication among all individual components • organisational change + ICT needed • Telecare & telemedicine (e.g. telerehabilitation, teleradiology, vital signs monitoring) can improve existing and stimulate new processes

  12. Potential service improvements for investigation locally • Move towards specialised, regionally merged or coordinated stroke services (incremental approach) • Use of telecare in community rehab (radical approach): • Monitoring equipment • Smart home technologies • ICT tools for staff and patients • Virtual visits

  13. Next steps • Identify and engage further stakeholders • Organise interviews and interactive workshops • Continue literature scanning • Simulation modelling • Cost analysis of possible alternatives

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