Development and implementation of the Ontario Stroke System: the use of evidence.
BACKGROUND
The Ontario Stroke System was developed to enhance the quality and continuity of stroke care provided across the care continuum.


OBJECTIVE
To identify the role evidence played in the development and implementation of the Ontario Stroke System.


METHODS
This study employed a qualitative case study design. In-depth interviews were conducted with six members of the Ontario Stroke System provincial steering committee. Nine focus groups were conducted with: Regional Program Managers, Regional Education Coordinators, and seven acute care teams. To supplement these findings interviews were conducted with eight individuals knowledgeable about national and international models of integrated service delivery.


RESULTS
Our analyses identified six themes. The first four themes highlight the use of evidence to support the process of system development and implementation including: 1) informing system development; 2) mobilizing governmental support; 3) getting the system up and running; and 4) integrating services across the continuum of care. The final two themes describe the foundation required to support this process: 1) human capacity and 2) mechanisms to share evidence.


CONCLUSIONS
This study provides guidance to support the development and implementation of evidence-based models of integrated service delivery.
Cameron
Jill I
JI
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto Rehabilitation Institute, Canada. jill.cameron@utoronto.ca
Rappolt
Susan
S
Lewis
Mary
M
Lyons
Renee
R
Warner
Grace
G
Silver
Frank
F