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The Victorian State Government implemented a programme of employing clinical Facilitators on a fixed\u2010term basis for up to 3 years (2008\u20132011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence\u2010based management protocols and provide staff education within an agreed work plan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine if the Facilitator role was associated with improved stroke care and to describe factors supporting or mitigating enhancements to care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A mixed methods design was employed with historical control using patient\u2010level audit data (pre\u2010Facilitator: <jats:italic>n<\/jats:italic> = 600; post\u2010Facilitator: <jats:italic>n<\/jats:italic> = 387) and qualitative data from independently conducted semistructured interviews with hospital staff, including clinicians, executives and facilitators (<jats:italic>n<\/jats:italic> = 10 focus groups; 75 respondents).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Stroke units, clinical pathways and outpatient clinics for managing transient ischaemic attacks (<jats:styled-content style=\"fixed-case\">TIA<\/jats:styled-content>) were established. Compared with the pre\u2010Facilitator period, significant increases in patient access to stroke unit care (53% vs 86%, <jats:italic>P<\/jats:italic> &lt; 0.001) and intravenous thrombolysis (2% vs 9%, <jats:italic>P<\/jats:italic> &lt; 0.001) were achieved. Hospital staff reported that the Facilitator was integral to system improvements by fostering communication, encouraging team motivation and cohesiveness and increasing interest in stroke care. Ongoing barriers included limited resources to operate <jats:styled-content style=\"fixed-case\">TIA<\/jats:styled-content> clinics effectively, staff turnover requiring ongoing education, inconsistency in compliance with protocols and, in some hospitals, the need for formalised medical leadership.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fixed\u2010term employment of Facilitators was effective in positively influencing stroke care in hospitals through a range of change management strategies where stroke\u2010specific expertise had been previously limited.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13458","type":"journal-article","created":{"date-parts":[[2017,4,19]],"date-time":"2017-04-19T12:14:42Z","timestamp":1492604082000},"page":"775-784","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Benefits of clinical facilitators on improving stroke care in acute hospitals: a new programme for Australia"],"prefix":"10.1111","volume":"47","author":[{"given":"Tara","family":"Purvis","sequence":"first","affiliation":[{"name":"Department of Medicine, School of Clinical Sciences at Monash Health Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Moss","sequence":"additional","affiliation":[{"name":"Stroke Division the Florey Institute of Neuroscience and Mental Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Francis","sequence":"additional","affiliation":[{"name":"School of Population and Global Health, Centre for Health Policy The University of Melbourne  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Borschmann","sequence":"additional","affiliation":[{"name":"Stroke Division the Florey Institute of Neuroscience and Mental Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique F.","family":"Kilkenny","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Sciences at Monash Health Monash University  Melbourne Australia"},{"name":"Stroke Division the Florey Institute of Neuroscience and Mental Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Denisenko","sequence":"additional","affiliation":[{"name":"Department of Health and Human Services Victorian Government  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher F.","family":"Bladin","sequence":"additional","affiliation":[{"name":"Stroke Division the Florey Institute of Neuroscience and Mental Health  Melbourne Australia"},{"name":"Eastern Health Clinical School Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8162-682X","authenticated-orcid":false,"given":"Dominique A.","family":"Cadilhac","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Sciences at Monash Health Monash University  Melbourne Australia"},{"name":"Stroke Division the Florey Institute of Neuroscience and Mental Health  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12371"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2007.024604"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.599738"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000245083.97460.e1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2010.02280.x"},{"key":"e_1_2_7_7_1","unstructured":"HarrisD RitchieE CadilhacD KilkennyM ReadS BoddiceG et al. 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