Exploring experiences of specialised rehabilitation services to co-design equitable model of care improvements: a qualitative study with patients, family, staff, and community providers.

Abstract

To enhance quality and equity in the model of care for specialised rehabilitation in a large regional service in Aotearoa New Zealand, this study aimed to explore the experiences and improvement ideas of patients, whaanau (wider family), staff and community providers. This qualitative study represents the experience capture phase of a service co-design project. Semi-structured interviews drawing on culturally informed methods were conducted with spinal, stroke and amputee patients (<i>n</i> = 14), whaanau (<i>n</i> = 7), staff (<i>n</i> = 14), and community organisation representatives (<i>n</i> = 10). Data were analysed using reflexive thematic analysis. Four overarching themes were generated: respecting the whole person and whaanau; fostering a collaborative rehabilitation culture; milestones and speedbumps on the road to recovery; and an enriching environment. Strengthening a holistic, person and whaanau-centred approach to specialised rehabilitation services may better support equitable outcomes. Priorities for service co-design are enhancing cultural safety and responsiveness, supporting whaanau, and enabling smooth transitions.