Patient experience of centralized acute stroke care pathways.
BACKGROUND
In 2010, Greater Manchester (GM) and London centralized acute stroke care services into a reduced number of hyperacute stroke units, with local stroke units providing on-going care nearer patients' homes.


OBJECTIVE
To explore the impact of centralized acute stroke care pathways on the experiences of patients.


DESIGN
Qualitative interview study. Thematic analysis was undertaken, using deductive and inductive approaches. Final data analysis explored themes related to five chronological phases of the centralized stroke care pathway.


SETTING AND PARTICIPANTS
Recruitment from 3 hospitals in GM (15 stroke patients/8 family members) and 4 in London (21 stroke patients/9 family members).


RESULTS
Participants were impressed with emergency services and initial reception at hospital: disquiet about travelling further than a local hospital was allayed by clear explanations. Participants knew who was treating them and were involved in decisions. Difficulties for families visiting hospitals a distance from home were raised. Repatriation to local hospitals was not always timely, but no detrimental effects were reported. Discharge to the community was viewed less positively.


DISCUSSION AND CONCLUSIONS
Patients on the centralized acute stroke care pathways reported many positive aspects of care: the centralization of care pathways can offer patients a good experience. Disadvantages of travelling further were perceived to be outweighed by the opportunity to receive the best quality care. This study highlights the necessity for all staff on a centralized care pathway to provide clear and accessible information to patients, in order to maximize their experience of care.
['Perry|Catherine|C|0000-0002-8496-6923', 'Papachristou|Iliatha|I|', 'Ramsay|Angus I G|AIG|', 'Boaden|Ruth J|RJ|', 'McKevitt|Christopher|C|0000-0002-5290-4613', 'Turner|Simon J|SJ|', 'Wolfe|Charles D A|CDA|', 'Fulop|Naomi J|NJ|0000-0001-5306-6140']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002497:Centralized Hospital Services D003422:Critical Care D005190:Family D005260:Female D006801:Humans D008131:London D008297:Male D008875:Middle Aged D017060:Patient Satisfaction D036301:Qualitative Research D020521:Stroke
stroke care centralization of services patient/carer experience