Exploring barriers to stroke coordinator roles in Australia: A national survey

Background: Coordinator roles are integral to delivering best practice stroke care. Evidence related to the challenges faced by clinicians working in these positions is lacking. Aim: To explore the barriers to working in acute stroke coordinator roles. Methods: Self-administered online national survey (including closed and open-text questions) of clinicians in coordinator roles in Australia. Non-physician health professionals who worked in a formal or informally recognised clinical leadership position for acute stroke were eligible. Participants were identified from the National Audit (Australia), and advertising via national networks/associations. Quantitative data were analysed descriptively, inductive thematic analysis was used for open-text responses, with all results triangulated. Findings: A total of 141 eligible clinicians were identified; 105 in coordinator roles responded (103 hospitals); and 96 answered questions related to barriers (91% female, 89% registered nurses). Having insufficient time to perform the role was a major barrier. In particular, having too many responsibilities (55%) and limited staffing allocation (45%) was perceived to impact care delivery. Inequity in classifications and remuneration, both within and across different states of Australia, were common concerns. Environmental barriers, particularly related to managerial support (31%), and associated acknowledgement and recognition of the role especially from executive/management, were frequently raised. Other challenges included limited professional development opportunities and funding support for ongoing education, and inadequate orientation to the role (27%). Conclusion: To develop and retain clinicians in coordinator roles for optimising stroke care, hospitals should address the modifiable barriers faced by those working in these positions, including greater formal recognition and sufficient employment fractions.