Identifying Clinician Perspectives on Current Stroke Care Gaps Across the Care Continuum: An Ontario, Canada-Focused Study.

BACKGROUND: Best-practice recommendations for stroke care are available worldwide, yet there are challenges implementing these guidelines, contributing to gaps in stroke care. Clinicians delivering stroke services can inform improvements in stroke care delivery and outcomes. OBJECTIVES: We aimed to conduct an in-depth examination of clinicians' perspectives on current gaps in stroke care throughout the entire care continuum, with a specific focus on the context of Ontario, Canada. DESIGN: This is a qualitative interpretive descriptive study. METHODS: Semi-structured interviews and focus groups were conducted with licensed clinicians who had experience providing stroke care in hospital or community settings in Ontario. The interviews were audio-recorded and transcribed verbatim. Analysis followed Thorne's interpretive description analysis techniques. RESULTS: Fourteen clinicians from five organizations participated in this study. Clinicians were occupational therapists (n=4), speech-language pathologists (n=5), physiotherapists (n=2), nurses (n=2), and a stroke coordinator (n=1). Clinicians identified the following four overarching gaps in patient- and family-centred stroke care: delays in recognition and response to stroke symptoms (theme 1), challenges in delivering and retaining stroke education (theme 2), variation in stroke care resources, quality, and rehabilitation access (theme 3), and gaps in continuity of care across the stroke care continuum (theme 4). CONCLUSION: The findings from this study offer critical insights into current gaps in stroke care. Addressing these patient- and family-centred gaps may improve the quality of stroke care and outcomes for patients and families.