Identification of barriers and enablers to rapid diagnosis along the paediatric stroke chain of recovery using Value-Focused Process Engineering

Mark T. Mackay, Leonid Churilov, Anna Moon, Ian McKenzie, Geoffrey A. Donnan, Paul Monagle, Qi Li and Franz E. Babl

Health Systems, 2021, vol. 10, issue 1, 73-88

Abstract: Coordinated systems of care are required to improve access to reperfusion therapies in paediatric stroke. A conceptual model was developed to map the process-of-care from symptom onset to confirmation of diagnosis. Value-Focused Process Engineering with event-driven process modelling was used to identify barriers and enablers to timely and accurate paediatric stroke diagnosis. Stakeholder interviews were conducted to inform model design, development, demonstration and validation. Barriers included: (i) ambulance dispatcher failure to allocate high-priority response, (ii) childrens’ exclusion from paramedic clinical practice guidelines, (ii) non-allocation of high triage category on hospital arrival, (iii) absence of emergency department guidelines for focal neurological deficits, and (iv) computed tomography as the first imaging investigation.Enablers included: (i) public awareness programs, (ii) childrens’ inclusion in prehospital emergency stroke algorithms, (iii) re-organisation of health services, with primary paediatric stroke centres, (iv) implementation of triage and neuroimaging decision support tools, and (iv) rapid stroke MRI imaging protocols.

Date: 2021
References: Add references at CitEc
Citations:

Downloads: (external link)
http://hdl.handle.net/10.1080/20476965.2019.1664941 (text/html)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:taf:thssxx:v:10:y:2021:i:1:p:73-88

Ordering information: This journal article can be ordered from
http://www.tandfonline.com/pricing/journal/thss20

DOI: 10.1080/20476965.2019.1664941

Access Statistics for this article

Health Systems is currently edited by Sally Brailsford

More articles in Health Systems from Taylor & Francis Journals
Bibliographic data for series maintained by Chris Longhurst ().