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Received Mar 8; Accepted Nov This article has been cited by other articles in PMC. Abstract Background Even though Swedish national guidelines for stroke care SNGSC have been accessible for nearly a decade access to stroke rehabilitation in out-patient health care vary considerably.
In order to aid future interventions studies for implementation of SNGSC, this study assessed the feasibility and acceptability of study procedures including analysis of the context in out-patient health care settings. Methods The feasibility and acceptability of recruitment, observations and interviews with managers, staff and patients were assessed, as well as the feasibility of surveying health care records.
Results To identify patients from the the hospitals was feasible but not from out-patient care where a need to relieve clinical staff of the recruitment process was identified.
Assessing adherence to guidelines and standardized evaluations of patient outcomes through health care records was found to be feasible and suitable assessment tools to evaluate patient outcome were identified. Interviews were found to be a feasible and acceptable tool to survey the context of the health care setting.
Conclusion In this feasibility study a variety of qualitative and quantitative data collection procedures and measures were tested.
The results indicate what can be used as a set of feasible and acceptable data collection procedures and suitable measures for studying implementation of stroke guidelines in an out-patient health care context.
Electronic supplementary material The online version of this article doi: Acceptability, Feasibility, Guidelines, Implementation, Stroke Background Stroke care and rehabilitation The Swedish National Guidelines for Stroke Care SNGSC targeted in this study are based on the principles of equal care, greatest support to those in greatest need and cost effectiveness, and provide a systematic review of current scientific knowledge for policy makers, managers and health practitioners [ 12 ].
Thus, the SNGSC may facilitate the equal allocation of health care resources and to support a high standard of health care [ 3 ]. Nevertheless, a national survey of stroke care in Sweden identified geographical inequalities in access to stroke care [ 4 ].
These findings indicate the necessity of bridging the gap between evidence-based knowledge and practice, and the need to explore ways to successfully facilitate the implementation of the national guidelines in clinical out-patient settings.
Implementing guidelines in clinical practice Multiple strategies directed at health professionals, such as written information, education, and audit and feedback are often used to facilitate implementation of guidelines in the clinical context, however their results are generally moderate [ 7 ].
In England and Canada, with a health care organisation comparable to the Swedish, user involvement was used to support implementation of stroke guidelines. A Delphi process used to develop a consensus document for implementation and focus groups and interviews preceded the development of user-friendly information regarding interventions in clinical practice.
Semi-structured interviews were used to assess the context where the guidelines, e. Individuals within an organization can positively or negatively affect an implementation process [ 9 ] but it has been argued that the context in which the evidence is to be implemented plays a crucial role in implementation of evidence [ 10 ].
In the conceptual framework Promoting Action on Research Implementation in Health Services PARIHScontext is included as a key factor comprising aspects such as organizational culture, evaluation of performance, and leadership [ 1112 ].
The extent to which leaders can facilitate change has been found to be related to their ability to tailor actions to fit the nature of the evidence and contextual conditions [ 13 ].
Sweden is structured in local authorities, comprising 20 regions and municipalities responsible for providing health care and welfare for the residents [ 14 ].
The regional organization of health care may differ as the local and regional health care authorities are mandated to allocate resources and organize health care autonomously [ 14 ]. At the Swedish health care units, the senior managers are responsible for enabling provision of safe and cost effective health care of good quality [ 15 ].
Another commonality is that outpatient rehabilitation post stroke should be initiated through a referral, by the stroke unit at the hospital to out-patient units. So far, little is known about how such contextual factors impact the implementation of guidelines in health care.
Other crucial factors to be targeted, recognized by the PARIHS framework, are the nature of the evidence and how the implementation of evidence is facilitated [ 9 ]. Piloting Implementation studies and other complex interventions should be preceded by pilot studies [ 1617 ] and as proposed by Feeley et al.
Thus, prior to a proposed full-scale study on a leadership intervention supporting managers in implementing guidelines, such as the SNGSC, the aim of this study was to explore the feasibility and acceptability of study procedures in data collection including a survey of the context of the health care setting.
In detail this paper reports on: In addition, a parallel paper reports on the results of piloting an intervention supporting the managers in the implementation of SNGSC. Methods Design This paper reports on a feasibility study, including both qualitative and quantitative data collection and analysis.
Setting Five out-patient units were identified to assess the feasibility of surveying diverse health care settings: The provision of out-patient stroke rehabilitation after discharge was organized differently in these settings. The included rehabilitation units were a part of a hospital organization 2 unitsb part of a district health care unit, c part of the municipality health and welfare and d a self-sufficient rehabilitation unit.
Four units provided home-based rehabilitation only and 3 units provided both home- and clinic-based rehabilitation. Recruitment of units, managers, staff and patients First, the senior managers at the identified units were contacted for informed consent.
After approval, each unit was requested to include a senior manager and a front line manager.Strategic evaluation 4 Suitability 5 Feasibility 6 • Resource Deployment 6 Acceptability 7 • Analysing Risks 7 6.
Conclusion 8 References 9 Appendix A 10 Strategic analysis of Apple Inc. /5(4). Jeffs, C , 'Suitability, feasibility and acceptability (sfa) of the strategy', in Strategic management, Sage Course Companions: Knowledge and Skills for Success, SAGE Publications Ltd, London, Suitability acts as a reassurance that the proposed strategy addresses Looks like you do not have access to this content.
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Strategic management assignment help writing analysis on: Case analysis on Sony and Apple’s performance The Suitability, Acceptability and Feasibility Criteria. Strategy.
Strategic Management: Apple Inc. suitability, and feasibility. Suitability requires one to assess whether proposed strategies address the key issues.
Acceptability measures whether proposed strategies meet the expectations of stakeholders. Also feasibility is measured whether /5(14K). Evaluating Business Strategy: Suitability, Feasibility & Acceptability Chapter 22 / Lesson 4 Transcript Video.
After completing the three stages, the strategic directions and methods has been furthered evaluated using Suitability, Feasibility and Acceptability check.
The last part of the report has set mission statement and the business objectives based on proposed strategic directions and the methods for the time span of 5 years.