Background: Access to rehabilitation has recently been identified as a pressing global need by the WHO at their 'Rehabilitation 2030: A call for action' meeting, Geneva, 2017. Inequity and opacity have been anecdotal features of accessing rehabilitation services for people after stroke in Australia.
Objectives: To ensure people with stroke get access to the right rehabilitation, at the right time, in the right place.
Methods: Ten years ago we embarked on a journey to redress stroke rehabilitation access issues in Australia by: quantifying the problem; forming a national expert working group; looking at the evidence for best practice; devising a framework and decision-making tool; and, piloting and then implementing these evidence-informed practices in 10 sites using a randomised and controlled trial design.
Results: From national audit data, our journey has achieved the objectives of improving consumer access for some and not others. So inequity is still an issue. We examine why this unacceptable variation in practice still exists, what role beliefs and values, resourcing and resistance to change may hold in explaining our results. We also find ourselves in the national guidelines - we ask ourselves is that a surrogate for success?
Conclusions: Our reflections on a ten-year program of change will be pertinent to the entire cycle of taking evidence to practice.