{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T01:36:32Z","timestamp":1793237792635,"version":"4.5.0"},"reference-count":18,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"unspecified","delay-in-days":42,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ontario Health\u2019s Models of Care Innovation Fund"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Qual"],"accepted":{"date-parts":[[2026,6,24]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patient-reported experience measures (PREM) are key indicators of healthcare quality linked to improved outcomes. The Canadian Stroke Best Practice Recommendations emphasise the importance of capturing patient perceptions of health services to enhance clinical outcomes in stroke care. Building on our previously established stroke-specific PREM, this quality improvement (QI) observational project aimed to gather stroke patient experience data to identify strengths and opportunities for improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This QI initiative was implemented in an acute stroke unit as part of the mobile transient ischaemic attack (TIA) and stroke with adaptive workflow project funded by Ontario\u2019s Ministry of Health. An interdisciplinary team of healthcare professionals and leadership members developed a survey focusing on patient journey themes. The survey was reviewed for readability and comprehension by two patients to ensure its appropriateness and relevance. The Institute for Healthcare Improvement model guided the initiative, with a project lead identifying eligible patients and a reactivation worker administering the surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 110 patients with stroke or TIA completed the survey over a 12-month observational period. Positive experience rates ranged from 90.0% to 99.1% across all seven domains, and no respondent selected disagree or strongly disagree on any item. Discharge readiness was the lowest-rated domain (90%), whereas a coordinated transition to the stroke unit achieved the highest ratings (99.1%). Inductive thematic analysis of open-ended responses identified three themes: (1) overall satisfaction, gratitude and quality of care; (2) patient-centred communication and emotional support and (3) isolated concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This QI initiative, building on previous work, showed positive patient experiences across all seven domains, with discharge readiness as a priority for improvement. The mixed-methods approach, which integrates quantitative Likert data with thematic analysis, offers a replicable model for patient-centred quality monitoring of stroke care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjoq-2025-003751","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T12:40:35Z","timestamp":1786538435000},"page":"e003751","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Patient experience and stroke care quality: a quality improvement initiative in Northeastern Ontario"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4919-6000","authenticated-orcid":false,"given":"Venkadesan","family":"Rajendran","sequence":"first","affiliation":[{"name":"Health Sciences North, Sudbury, Ontario, Canada"},{"name":"NOSM University, Sudbury, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9472-0243","authenticated-orcid":false,"given":"Susan","family":"Bursey","sequence":"additional","affiliation":[{"name":"Health Sciences North, Sudbury, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8004-5886","authenticated-orcid":false,"given":"Chantal","family":"Liddard","sequence":"additional","affiliation":[{"name":"Health Sciences North, Sudbury, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7803-7497","authenticated-orcid":false,"given":"Lisa","family":"Zeman","sequence":"additional","affiliation":[{"name":"Health Sciences North, Sudbury, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1201-8067","authenticated-orcid":false,"given":"Ravinder-Jeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Health Sciences North, Sudbury, Ontario, Canada"},{"name":"NOSM University, Sudbury, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"2026093022550578000_15.3.e003751.1","unstructured":"Public Health Agency of Canada . Ottawa (ON): PHAC; Stroke in Canada: Infographic, 2023. Available: https:\/\/www.canada.ca\/content\/dam\/canada\/public-health\/migration\/publications\/diseases-conditions-maladies-affections\/stroke-accident-vasculaire-cerebral\/alt\/64-03-1731_PHAC_Stroke-Infograph_eng.pdf"},{"key":"2026093022550578000_15.3.e003751.2","first-page":"795","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"20","year":"2019","journal-title":"Lancet Neurol"},{"key":"2026093022550578000_15.3.e003751.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjoq-2022-002073","article-title":"Routine measurement of patient experience","volume":"12","author":"Benson","year":"2023","journal-title":"BMJ Open Qual"},{"key":"2026093022550578000_15.3.e003751.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g2225","article-title":"Collecting data on patient experience is not enough: they must be used to improve care","volume":"348","author":"Coulter","year":"2014","journal-title":"BMJ"},{"key":"2026093022550578000_15.3.e003751.5","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.11.4.335"},{"key":"2026093022550578000_15.3.e003751.6","doi-asserted-by":"crossref","DOI":"10.1177\/23743735221125439","article-title":"Impact of Patient Engagement on Healthcare Quality: A Scoping Review","volume":"9","author":"Marzban","year":"2022","journal-title":"J Patient Exp"},{"key":"2026093022550578000_15.3.e003751.7","doi-asserted-by":"crossref","first-page":"2432","DOI":"10.1161\/STROKEAHA.120.034028","article-title":"Patient-Reported Experience Measures in Stroke Care: A Systematic Review","volume":"52","author":"Cornelis","year":"2021","journal-title":"Stroke"},{"key":"2026093022550578000_15.3.e003751.8","unstructured":"Walden J , Salama F , Powell-Jones Q , et al . Kingston (ON): Stroke Network of Southeastern Ontario and School of Rehabilitation Therapy, Queen\u2019s University; Evaluating patient experience in a community stroke rehabilitation program: development of a tool and evaluation plan, 2018. Available: https:\/\/www.strokenetworkseo.ca\/sites\/default\/files\/files\/patient_experience_eval_poster_portrait_qu.pdf [Accessed 19 Feb 2025]."},{"key":"2026093022550578000_15.3.e003751.9","doi-asserted-by":"crossref","DOI":"10.1177\/23743735261448450","article-title":"Improving Patient Experience and Discharge Readiness in Acute Stroke Care Through a Patient-Oriented Discharge Summary: A Two-Cycle Quality Improvement Study","volume":"13","author":"Rajendran","year":"2026","journal-title":"J Patient Exp"},{"key":"2026093022550578000_15.3.e003751.10","unstructured":"Institute for Healthcare Improvement . Boston (MA): Institute for Healthcare Improvement. Science of improvement: How to improve, Available: https:\/\/www.ihi.org\/resources\/Pages\/HowtoImprove\/ScienceofImprovementHowtoImprove.aspx [Accessed 19 Apr 2025]."},{"key":"2026093022550578000_15.3.e003751.11","doi-asserted-by":"publisher","DOI":"10.4300\/jgme-5-4-18"},{"key":"2026093022550578000_15.3.e003751.12","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_203_17: 10.4103\/sja.SJA_203_17"},{"key":"2026093022550578000_15.3.e003751.13","doi-asserted-by":"crossref","first-page":"83","DOI":"10.36401\/JQSH-21-X1","article-title":"A Practical Guide to Creating a Pareto Chart as a Quality Improvement Tool","volume":"4","author":"Alkiayat","year":"2021","journal-title":"Global Journal on Quality and Safety in Healthcare"},{"key":"2026093022550578000_15.3.e003751.14","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/23969873241272744","article-title":"Information needs of people who have suffered a stroke or TIA and their preferred approaches of receiving health information: A scoping review","volume":"10","author":"Helbach","year":"2025","journal-title":"Eur Stroke J"},{"key":"2026093022550578000_15.3.e003751.15","doi-asserted-by":"crossref","first-page":"7521","DOI":"10.2147\/JMDH.S563476","article-title":"Effectiveness of Discharge Planning Interventions for Stroke and Heart Conditions: A Systematic Review of Interventional Studies","volume":"18","author":"Ruksakulpiwat","year":"2025","journal-title":"J Multidiscip Healthc"},{"key":"2026093022550578000_15.3.e003751.16","doi-asserted-by":"crossref","first-page":"1465962","DOI":"10.3389\/fneur.2025.1465962","article-title":"Correlates of preparedness for caregiving of poststroke patients: a meta-analysis","volume":"16","author":"Li","year":"2025","journal-title":"Front Neurol"},{"key":"2026093022550578000_15.3.e003751.17","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2022.344"},{"key":"2026093022550578000_15.3.e003751.18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2015-004411"}],"container-title":["BMJ Open Quality"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjoq-2025-003751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:55:18Z","timestamp":1790834118000},"score":1,"resource":{"primary":{"URL":"https:\/\/qir.bmj.com\/lookup\/doi\/10.1136\/bmjoq-2025-003751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,8,12]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjoq-2025-003751"],"URL":"https:\/\/doi.org\/10.1136\/bmjoq-2025-003751","relation":{},"ISSN":["2399-6641"],"issn-type":[{"value":"2399-6641","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}