Improving the quality of care for people who had a stroke in a low-/middle-income country: A qualitative analysis of health-care professionals’ perspectives

Leonard Baatiema; Ama de-Graft Aikins; Fred S. Sarfo; Seye Abimbola; John K. Ganle; Shawn Somerset

doi:10.1111/hex.13027

Improving the quality of care for people who had a stroke in a low-/middle-income country: A qualitative analysis of health-care professionals’ perspectives

Leonard Baatiema, Ama de-Graft Aikins, Fred S. Sarfo, Seye Abimbola, John K. Ganle, Shawn Somerset

Research output: Contribution to journal › Article › peer-review

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Abstract

Background and Objective: Efforts to improve the adoption of evidence-based interventions for optimal patient outcomes in low-/middle-income countries (LMICs) are persistently hampered by a plethora of barriers. Yet, little is known about strategies to address such barriers to improve quality stroke care. This study seeks to explore health professionals’ views on strategies to improve quality stroke care for people who had a stroke in a LMIC. Methods: A qualitative interview study design was adopted. A semi-structured interview guide was used to conduct in-depth interviews among forty stroke care providers in major referral centres in Ghana. Participants were from nursing, medical, specialist and allied health professional groups. A purposive sample was recruited to share their views on practical strategies to improve quality stroke care in clinical settings. A thematic analysis approach was utilized to inductively analyse the data. Results: A number of overarching themes of strategies to improve quality stroke care were identified: computerization and digitization of medical practice, allocation of adequate resources, increase the human resource capacity to deliver stroke care, development of clinical guideline/treatment protocols, institutionalization of multidisciplinary care and professional development opportunities. These strategies were however differentially prioritized among different categories of stroke care providers. Conclusion: Closing the gap between existing knowledge on how to improve quality of stroke care in LMICs has the potential to be successful if unique and context-specific measures from the views of stroke care providers are considered in developing quality improvement strategies and health systems and policy reforms. However, for optimal outcomes, further research into the effectiveness and feasibility of the proposed strategies by stroke care providers is needed.

Original language	English
Pages (from-to)	450-460
Number of pages	11
Journal	Health Expectations
Volume	23
Issue number	2
DOIs	https://doi.org/10.1111/hex.13027
Publication status	Published - 1 Apr 2020

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@article{628a8e129dd34132b9295dd699c00868,

title = "Improving the quality of care for people who had a stroke in a low-/middle-income country: A qualitative analysis of health-care professionals{\textquoteright} perspectives",

abstract = "Background and Objective: Efforts to improve the adoption of evidence-based interventions for optimal patient outcomes in low-/middle-income countries (LMICs) are persistently hampered by a plethora of barriers. Yet, little is known about strategies to address such barriers to improve quality stroke care. This study seeks to explore health professionals{\textquoteright} views on strategies to improve quality stroke care for people who had a stroke in a LMIC. Methods: A qualitative interview study design was adopted. A semi-structured interview guide was used to conduct in-depth interviews among forty stroke care providers in major referral centres in Ghana. Participants were from nursing, medical, specialist and allied health professional groups. A purposive sample was recruited to share their views on practical strategies to improve quality stroke care in clinical settings. A thematic analysis approach was utilized to inductively analyse the data. Results: A number of overarching themes of strategies to improve quality stroke care were identified: computerization and digitization of medical practice, allocation of adequate resources, increase the human resource capacity to deliver stroke care, development of clinical guideline/treatment protocols, institutionalization of multidisciplinary care and professional development opportunities. These strategies were however differentially prioritized among different categories of stroke care providers. Conclusion: Closing the gap between existing knowledge on how to improve quality of stroke care in LMICs has the potential to be successful if unique and context-specific measures from the views of stroke care providers are considered in developing quality improvement strategies and health systems and policy reforms. However, for optimal outcomes, further research into the effectiveness and feasibility of the proposed strategies by stroke care providers is needed.",

keywords = "evidence-based care, health policy, low-/middle-income countries, quality improvement, quality of care, strategies, stroke, stroke care",

author = "Leonard Baatiema and {de-Graft Aikins}, Ama and Sarfo, {Fred S.} and Seye Abimbola and Ganle, {John K.} and Shawn Somerset",

note = "Funding Information: The first author (LB) was a PhD Candidate funded under the Australian Catholic University International Students Scholarship Programme, and at the time the study was conducted. LB was also financially supported by the University's Faculty of Health Science Higher Degree Research Student Support Scheme during his candidature. However, these funding bodies did not play a role in the study design, data collection and analysis, results interpretation and drafting of this manuscript or influenced our decision to submit to BMC Family Practice. Funding Information: The first author (LB) was a PhD Candidate funded under the Australian Catholic University International Students Scholarship Programme, and at the time the study was conducted. LB was also financially supported by the University's Faculty of Health Science Higher Degree Research Student Support Scheme during his candidature. However, these funding bodies did not play a role in the study design, data collection and analysis, results interpretation and drafting of this manuscript or influenced our decision to submit to Health Expectations. The authors duly appreciate the support received from the participating hospitals and all study participants. Publisher Copyright: {\textcopyright} 2020 The Authors Health Expectations published by John Wiley & Sons Ltd",

year = "2020",

month = apr,

day = "1",

doi = "10.1111/hex.13027",

language = "English",

volume = "23",

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journal = "Health Expectations",

issn = "1369-6513",

publisher = "Wiley-Blackwell",

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T2 - A qualitative analysis of health-care professionals’ perspectives

AU - Baatiema, Leonard

AU - de-Graft Aikins, Ama

AU - Sarfo, Fred S.

AU - Abimbola, Seye

AU - Ganle, John K.

AU - Somerset, Shawn

N1 - Funding Information: The first author (LB) was a PhD Candidate funded under the Australian Catholic University International Students Scholarship Programme, and at the time the study was conducted. LB was also financially supported by the University's Faculty of Health Science Higher Degree Research Student Support Scheme during his candidature. However, these funding bodies did not play a role in the study design, data collection and analysis, results interpretation and drafting of this manuscript or influenced our decision to submit to BMC Family Practice. Funding Information: The first author (LB) was a PhD Candidate funded under the Australian Catholic University International Students Scholarship Programme, and at the time the study was conducted. LB was also financially supported by the University's Faculty of Health Science Higher Degree Research Student Support Scheme during his candidature. However, these funding bodies did not play a role in the study design, data collection and analysis, results interpretation and drafting of this manuscript or influenced our decision to submit to Health Expectations. The authors duly appreciate the support received from the participating hospitals and all study participants. Publisher Copyright: © 2020 The Authors Health Expectations published by John Wiley & Sons Ltd

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Background and Objective: Efforts to improve the adoption of evidence-based interventions for optimal patient outcomes in low-/middle-income countries (LMICs) are persistently hampered by a plethora of barriers. Yet, little is known about strategies to address such barriers to improve quality stroke care. This study seeks to explore health professionals’ views on strategies to improve quality stroke care for people who had a stroke in a LMIC. Methods: A qualitative interview study design was adopted. A semi-structured interview guide was used to conduct in-depth interviews among forty stroke care providers in major referral centres in Ghana. Participants were from nursing, medical, specialist and allied health professional groups. A purposive sample was recruited to share their views on practical strategies to improve quality stroke care in clinical settings. A thematic analysis approach was utilized to inductively analyse the data. Results: A number of overarching themes of strategies to improve quality stroke care were identified: computerization and digitization of medical practice, allocation of adequate resources, increase the human resource capacity to deliver stroke care, development of clinical guideline/treatment protocols, institutionalization of multidisciplinary care and professional development opportunities. These strategies were however differentially prioritized among different categories of stroke care providers. Conclusion: Closing the gap between existing knowledge on how to improve quality of stroke care in LMICs has the potential to be successful if unique and context-specific measures from the views of stroke care providers are considered in developing quality improvement strategies and health systems and policy reforms. However, for optimal outcomes, further research into the effectiveness and feasibility of the proposed strategies by stroke care providers is needed.

AB - Background and Objective: Efforts to improve the adoption of evidence-based interventions for optimal patient outcomes in low-/middle-income countries (LMICs) are persistently hampered by a plethora of barriers. Yet, little is known about strategies to address such barriers to improve quality stroke care. This study seeks to explore health professionals’ views on strategies to improve quality stroke care for people who had a stroke in a LMIC. Methods: A qualitative interview study design was adopted. A semi-structured interview guide was used to conduct in-depth interviews among forty stroke care providers in major referral centres in Ghana. Participants were from nursing, medical, specialist and allied health professional groups. A purposive sample was recruited to share their views on practical strategies to improve quality stroke care in clinical settings. A thematic analysis approach was utilized to inductively analyse the data. Results: A number of overarching themes of strategies to improve quality stroke care were identified: computerization and digitization of medical practice, allocation of adequate resources, increase the human resource capacity to deliver stroke care, development of clinical guideline/treatment protocols, institutionalization of multidisciplinary care and professional development opportunities. These strategies were however differentially prioritized among different categories of stroke care providers. Conclusion: Closing the gap between existing knowledge on how to improve quality of stroke care in LMICs has the potential to be successful if unique and context-specific measures from the views of stroke care providers are considered in developing quality improvement strategies and health systems and policy reforms. However, for optimal outcomes, further research into the effectiveness and feasibility of the proposed strategies by stroke care providers is needed.

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KW - health policy

KW - low-/middle-income countries

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KW - quality of care

KW - strategies

KW - stroke

KW - stroke care

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ER -

Improving the quality of care for people who had a stroke in a low-/middle-income country: A qualitative analysis of health-care professionals’ perspectives

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