Bridges research and development projects

Bridges ‘All Wales’ stroke self-management project

 

We delivered Bridges self-management training to stroke practitioners in all Welsh University Health Boards and produced a Welsh language version of the stroke book

Final report for the Stroke Research and Innovation Fund All Wales Report April 2019

Partners

Welsh Government Stroke Implementation Group

The Problem

Since 2015 Bridges Self-Management training has been successfully received and implemented by stroke teams in Cardiff and Vale, Aneurin Bevan and Powys Health Boards.  Following this success local clinical leads wanted to make the approach available to stroke staff, patients and families throughout the rest of Wales.

Aims

- To deliver an integrated approach to self-management support for stroke across Wales, extending the reach and impact to a greater number of stroke survivors and their families.

- To evaluate the approach across Wales by collecting pre- and post-implementation data from stroke patients and their families (confidence to self-manage), stroke practitioners (self-management knowledge, beliefs and behaviours) and services (ways in which teams integrate self-management support into team processes).

- To utilise a whole systems approach to implementing a new intervention and support teams so that their approach to supporting self-management becomes normalised into everyday practice.

- To produce a Welsh language version of the Bridges book for people after stroke.

What We Did

Discovery: we travelled to Betsi Cadwaladr, Hywel Dda, Cwm Taf and Abertawe Bro Morgannwg University Health Boards to hold awareness raising sessions with stroke practitioners, to gather interest and momentum for the project.

Knowledge Zone 1: we delivered one-day training to acute and community stroke teams throughout the four University Health Boards and collected pre-implementation evaluation data from patients, their families and stroke practitioners.  At the same time, we delivered masterclasses to stroke practitioners in Cardiff and Vale, Powys and Aneurin Bevan University Health Boards who had been previously Bridges trained.

Transform: stroke practitioners had approximately three months to implement their initial plans for ways of working that could better support self-management.

Knowledge Zone 2: we delivered half-day follow-up training to the teams and practitioners visited in Knowledge Zone 1, where practitioners shared and learned from their efforts during the Transform stage and developed plans for ongoing implementation and sustainability. We collected post-implementation data and in addition learned about ways teams had implemented Bridges into their team processes.

Onwards: we held Masterclasses for practitioners from to Betsi Cadwaladr, Hywel Dda, Cwm Taf and Abertawe Bro Morgannwg University Health Boards to support ‘Bridges Champions’ to further develop plans to spread and sustain Bridges approach to self-management support within their services.  

Impact

- We held 10 two-stage workshops throughout four Welsh University Health Boards

- We delivered 4 masterclasses for Bridges trained stroke practitioners from all seven Welsh University Health Boards

- We produced a Welsh version of the Bridges stroke book for patients

- We delivered a summary of the project and outcomes at the Welsh Stroke Conference in June 2018

What We Learned

- It is possible to implement a shared approach to self-management at scale but each area and stroke unit is different

- Contextualisation and awareness raising is key

- It is necessary to modify delivery of training, and provide shorter sessions for frontline staff who cannot be released for one-day workshops

- Stroke practitioners in Wales are welcoming, receptive to new ideas and will give things a go!

Project Team

Fiona Jones, Founder and CEO, Bridges Self-Management

Emily Bourne and Debbie Shearring, Physiotherapy Students, Kingston and St. George’s University of London (evaluation support as part of MSc Physiotherapy)