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Evaluating the impact of a training program to support transitioning from the hospital to the community for people after stroke: a community case study


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Lui, M, McKellar, K, Cooper, S, Eng, JJ and Bird, M-L ORCID: 0000-0001-9642-7196 2022 , 'Evaluating the impact of a training program to support transitioning from the hospital to the community for people after stroke: a community case study' , BMC Health Services Research, vol. 22 , pp. 1-10 , doi: 10.1186/s12913-021-07436-7.

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BackgroundThe transitions in care along the stroke recovery path are challenging, particularly in finding mechanisms to continue one’s recovery once at home. We aim to evaluate the impact of training physiotherapists and fitness instructors from one regional community together to deliver an evidence-based group exercise program starting in the hospital and transitioning to the community using an implementation approach.MethodsThe evidenced based exercise program Fitness and Mobility Exercise (FAME) for stroke was chosen as the intervention. Data from interviews with stakeholders (community centre and health authority hospital staff including a physiotherapy navigator) was transcribed and themes evaluated using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. These data were supplemented by information collected as a quality assurance project within the health authority.ResultsTwo programs were established; one in the community centre (run over 15 months by fitness instructors) and one in the regional hospital (run over 12 months by a rehabilitation assistant under the direction from a physiotherapist). Transitions in care were facilitated by implementing the same evidence-based group exercise class in both the hospital and community setting, so people living with stroke could seamlessly move from one to another. An existing physiotherapist navigator service also was valued as a support for the transitions between the two centres for people with stroke. The hospital group accessed group-based physiotherapy service on average 31 days earlier than they were able to in a one-to-one format.ConclusionsThis case study described the implementation of the Fitness and Mobility Exercise (FAME) program in one community and the use of a physiotherapist navigator to assist transition between them. After a community training workshop, FAME programs were established within the health authority and the community centre. FAME program participants within the health authority benefited from reduced wait times to access hospital outpatient physiotherapy service. Improvements in function were measured in and reported by the people after stroke attending either the health authority or community centre FAME groups.

Item Type: Article
Authors/Creators:Lui, M and McKellar, K and Cooper, S and Eng, JJ and Bird, M-L
Keywords: physiotherapy, stroke rehabilitation, transitions, exercise, community navigation, implementation science
Journal or Publication Title: BMC Health Services Research
Publisher: Biomed Central Ltd
ISSN: 1472-6963
DOI / ID Number: 10.1186/s12913-021-07436-7
Copyright Information:

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, ( which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

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