BCW model policy level | ||||
Category | Service provision | Fiscal | Guidelines | |
Detail | Centralise hyperacute (HASU) care into 8 units situated to provide easy access to the whole population (no more than 30 min by ambulance) | Additional £21 m per year for acute stroke care but only paid under a new tariff if hospitals delivering the required quality | Pan-London Hyper Acute Stroke Nursing Competencies | |
BCW model intervention level | ||||
Category | Training; education | |||
Detail | Simulation training using a standardized protocol-based curriculum based on the London Cardiac and Stroke Network Model | |||
BCW model behavioural level | ||||
Category | Motivation | Psychological capability | Physical capability | Opportunity |
Detail | Forming good habits; increased knowledge and understanding; awareness of role | Cognitive and behavioural (‘non-technical’) skills: communication, management, teamwork | Clinical skills: history taking, assessment, treatment | Resources e.g. calling for help; use of all team members |
Main behaviour change techniques (BCTS) in simulation training | ||||
Repetition and substitution: habit formation (e.g. taking ‘time-out’ to verbalise situations); practice | ||||
Goals and planning: problem solving/coping planning in emergencies | ||||
Antecedents: restructuring social environment (e.g. breaking down hierarchies to encourage all voices) | ||||
Associations: prompts/cues (e.g. use of critical decision aids) | ||||
Comparison of behaviour: modeling; peer review | ||||
Comparison of outcomes: pros and cons of different approaches | ||||
Regulation: Regulation of negative emotions | ||||
Main outcomes | ||||
Reported knowledge; reported motivational and behavioural outcomes (staff survey and interview data); reported improvement in management and prevention of complications | ||||
Observed data on content, design/learning objectives and delivery |