Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings

The Top 100 Most-Cited Publications in Musculoskeletal Rehabilitation: A Bibliometric Analysis

BACKGROUND

Musculoskeletal conditions are the leading contributor to global healthcare expenditure and with an increase in ageing global population, this number is projected to rise further.

OBJECTIVES

To determine the top 100 most-cited studies in field of musculoskeletal rehabilitation and to conduct their bibliometric analysis.

DESIGN

Scopus was used for identification of studies, published in the field of musculoskeletal rehabilitation over last five decades.

METHODS

Literature search was conducted in February 2021 with final Boolean search phrases being: [(musculoskeletal) and (rehabilitation) and (musculoskeletal rehabilitation)]. In addition to number of citations, data was also collected for other variables such as title of study, topic of discussion, subdivisions of clinical and applied science involved in conduction of study, study design, journal and its impact factor, year of publication, and country where study was conducted.

RESULTS

The top 100 most-cited articles in musculoskeletal rehabilitation over the last 50 years were published between 1973 and 2015. Total number of citations was 24,366, with an average of 243.66 citations per paper. Highest citation was reported by a paper on treatment of low back pain by Waddell G. The decade of 2000-2009 contributed maximum articles with highest number of publications from journal "Archives of Physical Medicine and Rehabilitation". Most of the publications were from United States and most common topic to feature among these articles was "Strength training".

CONCLUSIONS

This study identifies the top 100 most-cited articles in musculoskeletal rehabilitation and provides insight into its historical trends while serving as a guide for future research.

Visual process maps to support implementation efforts: a case example

BACKGROUND

Process mapping is often used in quality improvement work to examine current processes and workflow and to identify areas to intervene to improve quality. Our objective in this paper is to describe process maps as a visual means of understanding modifiable behaviors and activities, in this case example to ensure that goals of care conversations are part of admitting a veteran in long-term care settings.

METHODS

We completed site visits to 6 VA nursing homes and reviewed their current admission processes. We conducted interviews to document behaviors and activities that occur when a veteran is referred to a long-term care setting, during admission, and during mandatory VA reassessments. We created visualizations of the data using process mapping approaches. Process maps for each site were created to document the admission activities for each VA nursing home and were reviewed by the research team to identify consistencies across sites and to identify potential opportunities for implementing goals of care conversations.

RESULTS

We identified five consistent behaviors that take place when a veteran is referred and admitted in long-term care. These behaviors are assessing, discussing, decision-making, documenting, and re-assessing.

CONCLUSIONS

Based on the process maps, it seems feasible that the LST note and order template could be completed along with other routine assessment processes. However, this will require more robust multi-disciplinary collaboration among both prescribing and non-prescribing health care providers. Completing the LST template during the current admission process would increase the likelihood that the template is completed in a timely manner, potentially alleviate the perceived time burden, and help with the provision of veteran-centered care.

User-Centered Design for Psychosocial Intervention Development and Implementation

The current paper articulates how common difficulties encountered when attempting to implement or scale-up evidence-based treatments are exacerbated by fundamental design problems, which may be addressed by a set of principles and methods drawn from the contemporary field of user-centered design. User-centered design is an approach to product development that grounds the process in information collected about the individuals and settings where products will ultimately be used. To demonstrate the utility of this perspective, we present four design concepts and methods: (a) clear identification of end users and their needs, (b) prototyping/rapid iteration, (c) simplifying existing intervention parameters/procedures, and (d) exploiting natural constraints. We conclude with a brief design-focused research agenda for the developers and implementers of evidence-based treatments.