Emergency care network: stroke care

Abstract

Objective: To analyze how the care of patients with acute ischemic stroke occurs, considering the care flows and the restrictive and facilitating elements of care in the emergency care network. Methods: This is a study based on the Grounded Theory methodological framework. We interviewed 75 health professionals from the Brazilian Mobile Emergency Care Service, Emergency Care Unit and reference hospital in the city of Salvador, Bahia. Results: A total of 14 categories and 66 subcategories emerged that represented the phenomenon studied, revealing causal factors of network fragmentation such as lack of vacancies and resources, need for improvement in the care protocol, hospital bureaucratization, lack of knowledge by the population, despite the efforts of professionals to meet this patient. Professional interaction revealed the absence of a single language, obstacles in professional relationships, lack of knowledge of the other’s role, difficulty in regulating patients and sharing some goals in the network. Consequently, patients left the care line, care for patients outside the therapeutic window, the need to impose a ‘zero vacancy’, and better care when patients had access to specialized unit. Facilitating elements also concern the sharing of goals in the network and the effort of professionals to attend to window patients. Conclusion: The network fragmentation reveals the need for management interventions to improve care, standardizing it and making care comprehensive and equitable.