Improving the interface for information transfer in acute stroke care: a mixed-methods process evaluation of the emergency use case within the CAEHR project.

OBJECTIVE: Prehospital notification by emergency medical services (EMS) can activate hospital resources before the patient arrives, which has been shown to improve in-hospital care for stroke patients. Optimising prehospital and handover processes in stroke care requires considering end-user perspectives to enhance acceptance and effectiveness of the developed solutions. The aim of this study was to identify current barriers in the preclinical-clinical phase of stroke care. DESIGN AND SETTING: Within the investigator-initiated CAEHR project (CArdiovascular diseases-Enhancing Healthcare through cross-sectoral Routine data integration), an interface for transferring data from the electronic prenotification system to the hospital information system is implemented. A mixed-methods approach with semi-structured interviews as well as a cross-sectional online survey was used to gather feedback from healthcare professionals at a single stroke centre in Germany as well as from the participating EMS personnel. Data collection for the interviews was conducted between January and August 2023 and for the online survey between May and September 2023. PARTICIPANTS: Interviews were conducted with 10 healthcare professionals, including seven from the neurological clinic and three from EMS. Additionally, 39 EMS employees took part in a cross-sectional online survey. RESULTS: Challenges identified were educational and training aspects affecting preclinical processes and patient handover procedures, along with the opportunity for establishing more uniform protocols. Participants emphasised the importance of detailed patient information. Electronic prenotification was seen as an important step regarding structured information transmission, reducing the risk of information loss in stroke care. CONCLUSION: The study highlights the importance of addressing organisational processes in addition to technical interfaces for implementing effective stroke care processes. TRIAL REGISTRATION NUMBER: German Clinical Trials Register, DRKS00029103.