Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2026
Summary
A lived-experience stroke survivor was embedded into rural stroke care to improve patient understanding, emotional wellbeing and recovery through a scalable volunteer model.
Dates: October 2024 - September 2025
Implementation sites: Townsville University Hospital
Partnerships: Volunteer services Wide Bay HHS
Aim
To strengthen rural stroke care by implementing a holistic, low-cost, lived-experience volunteer model that improves patient comprehension and emotional support.
Outcomes
- Improved patient-reported understanding of stroke, recovery, and expectations following discharge.
- Improved emotional reassurance and reduced anxiety during the acute phase. Earlier and more consistent identification of psychosocial, educational, and family‑support needs.
- Stronger communication between patients, families, volunteers, and clinicians.
- Feedback being reflected in clinical quality improvement.
Background
Stroke remains a leading cause of disability, and recovery extends well beyond the acute hospital admission. For many individuals, the days and weeks following a stroke are marked by uncertainty, fear, and a need for clear guidance. These challenges are intensified in regional and remote settings, where access to specialist stroke services, community supports, and psychosocial care is often limited. 43% of Australians living with stroke live in Federal electoral divisions that are classed as regional areas. Due to this reason stroke patients have less access to rehabilitation services and supports.
Patients and families frequently report feeling overwhelmed, isolated, and under‑prepared for life after stroke, particularly at the point of discharge when support needs are highest. At Hervey Bay Hospital, clinicians recognised a significant gap in the provision of holistic, person‑centred support for patients experiencing stroke or transient ischaemic attack (TIA). While clinical care was well‑established, patients consistently expressed unmet needs related to emotional wellbeing, family engagement, and understanding of the recovery process. These challenges were further amplified by familiar rural health constraints, including workforce shortages, limited access to specialist stroke clinicians, and fewer local community services to support post‑hospital recovery.
To address this need, the team partnered with a local stroke survivor who experienced a stroke at a young age more than 25 years ago and has lived with the long‑-term physical, emotional, and psychosocial consequences of stroke. Her willingness to “give back” and support others provided a unique opportunity to embed meaningful lived experience within the stroke care pathway. Through co‑design processes with the survivor, Clinical Nurse Consultant, and the hospital’s Volunteer Program, a structured and safe peer support volunteer role was developed. This model enables the volunteer to provide bedside peer support to consenting inpatients following stroke or TIA. The volunteer offers empathy, understanding, shared experience, and non‑-clinical guidance-filling a gap that clinical staff often lack time or lived perspective to address. Patients and families gain a relatable source of reassurance, practical preparation for recovery, and an opportunity to discuss fears and expectations with someone who has personally navigated the journey.
This model enables the volunteer to provide bedside peer support to consenting inpatients following stroke or TIA. The volunteer offers empathy, understanding, shared experience, and non‑clinical guidance-filling a gap that clinical staff often lack time or lived perspective to address. Patients and families gain a relatable source of reassurance, practical preparation for recovery, and an opportunity to discuss fears and expectations with someone who has personally navigated the journey.
A key innovation is the integration of volunteer documentation and communication pathways. Insights from patient conversations, psychosocial concerns, and emerging themes are relayed directly to the CNC, supporting more responsive care planning. Early implementation demonstrated improved patient understanding, strengthened confidence, enhanced emotional support, and more effective identification of unmet needs. Clinicians reported increased awareness of issues such as stroke fatigue, recovery misconceptions, and the minimisation of TIA symptoms.
Methods
A qualitative quality improvement approach was used to design, implement, and refine a lived experience peer support model for stroke and TIA patients at Hervey Bay Hospital. The project followed Plan Do Study Act (PDSA) improvement principles to ensure iterative learning, patient centred adaptation, and sustainability within a rural context.
What we did: The project began with a local gap analysis to understand existing strengths and deficiencies in stroke support services. This assessment examined the availability of specialist stroke clinicians, psychosocial support programs, community rehabilitation
options, and patient education resources in the region. The analysis confirmed significant limitations in post stroke peer support, emotional support, and holistic recovery guidance, particularly during the inpatient phase and transition home.
Co-design and Development of the Initiative: Through collaborative design workshops with the Clinical Nurse Consultant (CNC) and the hospital’s Volunteer Program, a structured lived experience volunteer role was developed. This included a clear role description, boundaries, expected tasks, consent processes, escalation pathways, and mechanisms for communicating patient identified concerns back to clinical staff. Engagement strategies were intentionally designed around the volunteer’s lived experience, personal capacity, and lifestyle to support long term sustainability.
The initiative aimed to embed lived experience safely and meaningfully within existing clinical workflows without adding burden to clinicians. Implementation of the Initiative: Once onboarded through the formal hospital Volunteer Program, the volunteer began engaging with consenting stroke and TIA inpatients. Interactions were patient led and flexible, allowing the volunteer to provide emotional reassurance, shared understanding, and time for meaningful conversation-elements often difficult for clinical teams to deliver consistently due to workload pressures. Early in implementation, feedback from clinicians and the volunteer highlighted the need for structured documentation to capture these interactions and improve continuity.
In response, progress note templates and a formalised feedback pathway to the CNC were introduced. This ensured key psychosocial insights and patient expressed concerns were integrated into care planning. How we evaluated it: A qualitative evaluation framework
was used to capture patient experiences, family perspectives, volunteer reflections, and clinician observations. Open ended feedback allowed themes to emerge naturally, recognising that each stroke journey is unique and that lived experience encounters often
prompt emotional or personal disclosures not suited to restrictive surveys.
Data captured included:
- patient perceptions of understanding and confidence
- emotional responses during and after peer interactions
- family feedback on support and communication
- clinician observations regarding patient engagement and care needs
- volunteer reflections on emerging themes and system gaps
Improvement Methodology: Using PDSA cycles, the team continuously refined the model. Adjustments included optimising visit timing around fatigue patterns, enhancing TIA specific education due to recurring misconceptions, and improving documentation pathways. Insights from lived experience informed ongoing modifications to clinical workflows and patient education strategies.
Discussion
Environment and context – What was needed to succeed This project succeeded because of strong consumer partnership, clear governance, and organisational support for an innovative volunteer model within a rural hospital.
Enablers included: a supportive Clinical Nurse Consultant (CNC), mature Volunteer Program infrastructure (onboarding, role clarity, consent, escalation), and open communication across the stroke care team. Embedding lived experience within routine workflows created trust, relatability, and psychological safety for patients at a vulnerable time, while ensuring clinical oversight and safe boundaries.
Lessons learned and limitations: Key learnings included the importance of brief, patient‑led engagements due to variable stroke fatigue; the need for targeted education for TIA patients who often underestimated the seriousness of their condition; and the value of structured documentation to capture psychosocial insights.
Limitations included reliance on a single volunteer (sustainability risk), qualitative rather than quantitative measurement in early phases, and variable availability due to volunteer capacity. As a non‑-clinical role, the volunteer could not address complex medical questions—reinforcing the need for rapid escalation pathways and clinician follow‑up.
Strengths, Weaknesses, and Opportunities Strengths: Low‑cost, high‑value model; authentic peer connection; improved patient understanding and confidence; timely feedback loops to clinicians; and strong fit for rural constraints.
Weaknesses: Initial lack of formal metrics; coverage limited to specific days/times; potential role ambiguity without ongoing education for staff.
Opportunities: build a small peer pool to ensure continuity; add brief, patient-reported outcome measures; develop TIA‑specific education prompts; extend the model to other wards (e.g., rehab, medical) and conditions (cardiac, oncology, long‑COVID, neurological). There is also an opportunity to embed peer insights into discharge planning, teach-back education, and staff training.
What we would do differently: From the outset, we would:
- Co-design a short, standardised patient‑reported survey (understanding, confidence, emotional support).
- Define core documentation fields and a simple dashboard for themes and referrals.
- Plan coverage using a small cohort of trained peers to reduce single‑point dependency.
- Develop micro‑education scripts for TIA and common misconceptions.
- Establish structured debrief and wellbeing supports for volunteers to maintain longevity.
Where else in Queensland Health this could succeed: This model is well suited to other rural and regional hospitals and multipurpose services where specialist resources are limited. It is also transferable to outpatient stroke clinics, rehabilitation units, and Hospital in the Home. Beyond stroke, it aligns with chronic and complex care pathways-cardiac rehab, COPD, diabetes, oncology, renal, mental health, persistent pain, neurological conditions - where lived experience can enhance engagement, self-management, and transition planning.
Next steps: Formalise evaluation: introduce brief patient‑reported measures, track referrals/actions, and analyse qualitative themes. Build capacity: recruit and train additional peers; implement structured supervision and wellbeing supports.
Standardise processes: Refine documentation templates, escalation criteria, and handover pathways.
Scale and spread: Pilot in rehab/outpatient settings; develop an implementation toolkit and training package for other sites.
Sustain: Integrate into service plans and quality dashboards; present findings to governance and regional networks to support broader adoption.
References
EBSCO Research Starters. (2024). PDSA cycle. https://www.ebsco.com/research-starters/health-and-medicine/pdsa-cycle
American Heart Association. (n.d.). Targeted nursing interventions for improving stroke care and outcomes in the rural setting: A scientific statement. https://www.ahajournals.org/doi/pdf/10.1161/STR.0000000000000495 March of Dimes Canada. (2024).
After stroke peer support toolkit: A guide to develop, deliver and maintain group‑-based peer support. https://www.afterstroke.ca/wp-content/uploads/2025/01/Peer-Support-Tookit.pdf American Stroke Association. (2023). Peer support: A critical component to stroke recovery. https://www.stroke.org/en/stroke-connection/stroke-onward/peer-support
Key contact
Torrie Scott-Paku
Clinical Nurse Consultant
Hervey Bay Hospital