Understanding Coordinator Roles in Acute Stroke Care: A National Survey

Tara Purvis; Sandy Middleton; Anne W Alexandrov; Monique F Kilkenny; Skye Coote; Sarah Kuhle; Dominique A Cadilhac

doi:10.1016/j.jstrokecerebrovasdis.2021.106111

Understanding Coordinator Roles in Acute Stroke Care: A National Survey

J Stroke Cerebrovasc Dis. 2021 Dec;30(12):106111. doi: 10.1016/j.jstrokecerebrovasdis.2021.106111. Epub 2021 Sep 29.

Authors

Tara Purvis¹, Sandy Middleton², Anne W Alexandrov³, Monique F Kilkenny⁴, Skye Coote⁵, Sarah Kuhle⁶, Dominique A Cadilhac⁴

Affiliations

¹ Translational Public Health and Evaluation Division, Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia. Electronic address: tara.purvis@monash.edu.
² Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australia; Australian Catholic University, Sydney, New South Wales, Australia.
³ College of Nursing & College of Medicine, and Department of Neurology, University of Tennessee Health Science Center, Tennessee, United States of America.
⁴ Translational Public Health and Evaluation Division, Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; Stroke Division, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia.
⁵ Melbourne Brain Centre and Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁶ Statewide Stroke Clinical Network, Queensland Health, Herston, Queensland, Australia.

PMID: 34600180
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106111

Abstract

Objectives: Coordinators contribute to stroke care quality. Evidence on the scope of practice of coordinator roles for stroke is lacking. We aimed to survey Australian stroke coordinators and describe their responsibilities and characteristics, and compare these based on perceived competency.

Materials and methods: Online survey of non-physician coordinators with a clinical leadership position for acute stroke in Australian hospitals. Participants were identified from the Stroke Foundation National Audit, and advertising via national associations/networks. Quantitative data were analysed descriptively; characteristics and responsibilities assessed by Benner's self-perceived competency (novice/advanced beginner/competent, proficient or expert). Inductive thematic analysis was used for open-ended responses.

Results: Results from 105/141 coordinators (103 hospitals, 90% female, 90% registered nurses). Two-thirds developed the role/were self-taught, with 36% using the 'stroke coordinator' title. Perceived competency varied; 22% expert, 40% proficient, and 33% competent. A variety of important clinical tasks, along with leadership/management, education and research responsibilities were described. Most frequently reported clinical responsibility was discharge planning (77%), with patient and staff education (85% and 88%), and data collection (94%) common. Compared to those reporting lesser competency, 'experts' had greater involvement in outpatient clinics (50% vs 14%) and leadership/management responsibilities (e.g. local hospital committees 77% vs 46%). 'Knowledge of evidence' and 'empowering others' were important characteristics to 'expert' coordinators.

Conclusions: A contemporary understanding of important responsibilities and characteristics of acute stroke coordinators are provided. Perceived competency affected scope of practice. Structured education, training and role delineation is warranted to improve competency. Career development of stroke coordinators is urgently needed to support optimal role performance.

Keywords: Acute; Characteristics; Competency; Coordinator; Facilitator; Responsibilities; Scope; Stroke.

MeSH terms

Australia
Critical Care* / organization & administration
Female
Hospitals
Humans
Leadership
Male
Professional Role*
Stroke* / therapy
Surveys and Questionnaires