The impact of telemedicine enabled pre-hospital triage in acute stroke – a protocol for a mixed methods systematic review [version 2; peer review: 2 approved]
Introduction Increasing access to thrombolysis and thrombectomy through improved pathway organisation remains a health service challenge that requires contextualisation to the geographic, demographic and resourcing status of any regional stroke service. Pre-hospital delays or delays during inter-hos...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2023-10-01
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| Series: | HRB Open Research |
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| Online Access: | https://hrbopenresearch.org/articles/5-32/v2 |
| _version_ | 1797633334598172672 |
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| author | David Williams Deirdre McCartan Jorin Bejleri Stuart Lee Anne Hickey Paul Murphy |
| author_facet | David Williams Deirdre McCartan Jorin Bejleri Stuart Lee Anne Hickey Paul Murphy |
| author_sort | David Williams |
| collection | DOAJ |
| description | Introduction Increasing access to thrombolysis and thrombectomy through improved pathway organisation remains a health service challenge that requires contextualisation to the geographic, demographic and resourcing status of any regional stroke service. Pre-hospital delays or delays during inter-hospital transfers can result in patients being outside the window for one or both interventions. Pre-hospital triage using technology-enabled interdisciplinary communication networks may facilitate rapid individualized care decisions, permitting streamlined care pathways to hospital sites most appropriate to their clinical presentation and history in the first instance. Understanding the experience of those involved in efforts to improve or reorganise care may help to explain the impact observed. Objectives 1. To review the impact of pre-hospital telemedicine enabled workflow intervention strategies on patient outcomes and on service process metrics in hyper-acute stroke care 2. To examine how the experience of those involved in providing or receiving such interventions might identify key characteristics of effective interventions Inclusion criteria Quantitative, qualitative and primary mixed methods studies will be included. Quantitative studies will assess effectiveness of telemedicine-enabled interventions that facilitate pre-hospital acute stroke triage. Intervention effects on functional outcomes of patients, on intervention rates and on key time metrics in hyperacute stroke care will be assessed. Qualitative studies will explore the experiences of people involved in or impacted by these interventions. Methods and analysis A convergent segregated mixed methods systematic review will synthesise and integrate primary qualitative, quantitative and mixed methods studies using the Joanna Briggs Institute methodology. Database searches will include OVID (MEDLINE), EMBASE, The Cochrane Library, CINAHL and Web of Science. Critical appraisal will include the Mixed Methods Assessment Tool. Results of quantitative studies and findings of qualitative studies will be integrated and configured to explore and contextualize each single method synthesis. Systematic review registration This protocol has been submitted for registration with PROSPERO. |
| first_indexed | 2024-03-11T11:52:39Z |
| format | Article |
| id | doaj.art-3ba6b09743434847b6632ce4ca2dc48f |
| institution | Directory Open Access Journal |
| issn | 2515-4826 |
| language | English |
| last_indexed | 2024-03-11T11:52:39Z |
| publishDate | 2023-10-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | HRB Open Research |
| spelling | doaj.art-3ba6b09743434847b6632ce4ca2dc48f2023-11-09T01:00:00ZengF1000 Research LtdHRB Open Research2515-48262023-10-01515138The impact of telemedicine enabled pre-hospital triage in acute stroke – a protocol for a mixed methods systematic review [version 2; peer review: 2 approved]David Williams0https://orcid.org/0000-0002-1923-462XDeirdre McCartan1https://orcid.org/0000-0003-1798-4686Jorin Bejleri2https://orcid.org/0000-0002-8186-4075Stuart Lee3Anne Hickey4https://orcid.org/0000-0003-0008-3195Paul Murphy5iPASTAR Collaborative Doctoral Award Programme, Division of Population Health Sciences, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, IrelandiPASTAR Collaborative Doctoral Award Programme, Division of Population Health Sciences, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, IrelandSchool of Medicine, RCSI University of Medicine and Health Sciences, Dublin, IrelandStroke Medicine/Gerontology, Beaumont Hospital, Dublin, IrelandiPASTAR Collaborative Doctoral Award Programme, Division of Population Health Sciences, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, IrelandRCSI Library, Royal College of Surgeons in Ireland, Dublin, IrelandIntroduction Increasing access to thrombolysis and thrombectomy through improved pathway organisation remains a health service challenge that requires contextualisation to the geographic, demographic and resourcing status of any regional stroke service. Pre-hospital delays or delays during inter-hospital transfers can result in patients being outside the window for one or both interventions. Pre-hospital triage using technology-enabled interdisciplinary communication networks may facilitate rapid individualized care decisions, permitting streamlined care pathways to hospital sites most appropriate to their clinical presentation and history in the first instance. Understanding the experience of those involved in efforts to improve or reorganise care may help to explain the impact observed. Objectives 1. To review the impact of pre-hospital telemedicine enabled workflow intervention strategies on patient outcomes and on service process metrics in hyper-acute stroke care 2. To examine how the experience of those involved in providing or receiving such interventions might identify key characteristics of effective interventions Inclusion criteria Quantitative, qualitative and primary mixed methods studies will be included. Quantitative studies will assess effectiveness of telemedicine-enabled interventions that facilitate pre-hospital acute stroke triage. Intervention effects on functional outcomes of patients, on intervention rates and on key time metrics in hyperacute stroke care will be assessed. Qualitative studies will explore the experiences of people involved in or impacted by these interventions. Methods and analysis A convergent segregated mixed methods systematic review will synthesise and integrate primary qualitative, quantitative and mixed methods studies using the Joanna Briggs Institute methodology. Database searches will include OVID (MEDLINE), EMBASE, The Cochrane Library, CINAHL and Web of Science. Critical appraisal will include the Mixed Methods Assessment Tool. Results of quantitative studies and findings of qualitative studies will be integrated and configured to explore and contextualize each single method synthesis. Systematic review registration This protocol has been submitted for registration with PROSPERO.https://hrbopenresearch.org/articles/5-32/v2Acute stroke thrombolysis thrombectomy primary stroke centre (PSC) comprehensive stroke centre (CSC) prehospitaleng |
| spellingShingle | David Williams Deirdre McCartan Jorin Bejleri Stuart Lee Anne Hickey Paul Murphy The impact of telemedicine enabled pre-hospital triage in acute stroke – a protocol for a mixed methods systematic review [version 2; peer review: 2 approved] HRB Open Research Acute stroke thrombolysis thrombectomy primary stroke centre (PSC) comprehensive stroke centre (CSC) prehospital eng |
| title | The impact of telemedicine enabled pre-hospital triage in acute stroke – a protocol for a mixed methods systematic review [version 2; peer review: 2 approved] |
| title_full | The impact of telemedicine enabled pre-hospital triage in acute stroke – a protocol for a mixed methods systematic review [version 2; peer review: 2 approved] |
| title_fullStr | The impact of telemedicine enabled pre-hospital triage in acute stroke – a protocol for a mixed methods systematic review [version 2; peer review: 2 approved] |
| title_full_unstemmed | The impact of telemedicine enabled pre-hospital triage in acute stroke – a protocol for a mixed methods systematic review [version 2; peer review: 2 approved] |
| title_short | The impact of telemedicine enabled pre-hospital triage in acute stroke – a protocol for a mixed methods systematic review [version 2; peer review: 2 approved] |
| title_sort | impact of telemedicine enabled pre hospital triage in acute stroke a protocol for a mixed methods systematic review version 2 peer review 2 approved |
| topic | Acute stroke thrombolysis thrombectomy primary stroke centre (PSC) comprehensive stroke centre (CSC) prehospital eng |
| url | https://hrbopenresearch.org/articles/5-32/v2 |
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