Lay summary
Stroke affects over 9,000 New Zealanders every year. Māori and Pacific have worse outcomes, including experiencing stroke 15-years earlier than non-Māori. Geographic inequities persist, disadvantaging rural populations. Resulting disabilities contribute to stroke patients feeling stigmatised. Management of Fever, Sugar and Swallow (FeSS Protocols) for 72-hours post-stroke is evidence-based care, included in the current stroke guidelines and, when implemented, known to reduce death and disability for all stroke patients. FeSS Protocols can be provided in all hospitals across Aotearoa. However implementation remains sub-optimal. The Quality in Acute Stroke Care (QASC) study will evaluate different levels of remote facilitation to support staff to implement the FeSS Protocols. Facilitation supports clinical staff achieve specific goals through behaviour change. Hospitals will be allocated to either high or low-levels facilitation, or current ‘usual’ practice. QASC includes an economic and implementation evaluation. Increasing FeSS Protocol implementation will improve equity and outcomes for stoke patients across Aotearoa.