Introduction:
Targets for recommended therapy provision are routinely audited as part of the Sentinel Stroke National Audit Program (SSNAP). However, research evidence consistently shows patient activity outside of scheduled therapy is very limited, with patients reportedly inactive between 60-80% of the day.
The Collaborative Rehabilitation Environments in Acute Stroke (CREATE) study aims to evaluate the feasibility and impact of patients, carers and clinicians co-producing and implementing interventions to increase supervised and independent therapeutic patient activity in acute stroke units.
Experience-based co-design (EBCD) will be used as a co-production approach to facilitate joint development of interventions to increase inpatient activity.

Method
The CREATE study will use a mixed methods, case comparison design.
Following a rapid review of co-production in acute healthcare, we will initiate the 6 stages of EBCD to co-produce inter-ventions and evaluate the impact on supervised and independent therapeutic activity in four stroke units (Fig. 1).
Pre and post implementation data collection will comprise non-participant observations and behaviour mapping of patient activity and PROM / PREM data. An evaluation of the experience of taking part in EBCD will also be carried out.

Conclusion
The rapid review will be completed by July 2016 and will generate transferable findings for other acute healthcare settings.
Site set up has commenced in the first 2 stroke units based in London and Yorkshire, and 2 further stroke units will be recruited for the final phase in June 2017. The study will be completed in 2019.

• Organisation