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Reimagining Stroke Rehabilitation and Recovery Across the Care Continuum: Results From a Design-Thinking Workshop to Identify Challenges and Propose Solutions

  • Julie A. DiCarlo
    Affiliations
    Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • Galina Gheihman
    Affiliations
    Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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  • David J. Lin
    Correspondence
    Corresponding author David J. Lin, MD, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, 175 Cambridge Street, Suite 300, Boston, MA 02114.
    Affiliations
    Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA

    Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA

    Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston, MA
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  • on behalf of the2019 Northeast Cerebrovascular Consortium Conference Stroke Recovery Workshop Participants
Published:February 05, 2021DOI:https://doi.org/10.1016/j.apmr.2021.01.074

      Abstract

      Systems for stroke rehabilitation and recovery are variable and fragmented; stroke survivors often experience gaps in care with detrimental effects on their recovery. We designed and hosted a multidisciplinary and interactive workshop to discuss challenges facing patients recovering from stroke and to brainstorm solutions.
      Forty-one participants including clinicians, researchers, and stroke survivors attended the workshop. Participants were surveyed beforehand about challenges facing stroke recovery and results were tabulated as a word cloud. An interactive, design-thinking exercise was conducted that involved completing workbooks, hands-on prototype designing, and presentations, which were then analyzed through qualitative content analysis using an inductive approach.
      High frequency words in the word cloud of survey responses included access, fragmented, and uncertainty. Qualitative analysis revealed 6 major challenge themes including poor (1) transitions in and (2) access to care; (3) barriers to health insurance; (4) lack of patient support; (5) knowledge gaps; and (6) lack of standardized outcomes. Eleven unique solutions were proposed that centered around new technologies, health care system changes, and the creation of new support roles. Analysis of the alignment between the challenges and solutions revealed that the single proposed solution that solved the most identified challenges was a “comprehensive stroke clinic with follow-up programs, cutting edge treatments, patient advocation and research.”
      Through our interactive design-thinking workshop process and inductive thematic analysis, we identified major challenges facing patients recovering from stroke, collaboratively proposed solutions, and analyzed their alignment. This process offers an innovative approach to reaching consensus among interdisciplinary stakeholders.

      Keywords

      List of abbreviations:

      NECC (The Northeast Cerebrovascular Consortium)
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