1
|
Levine R, Zingelman S, McSween MP, Shrubsole K, Hill AJ, Copland DA. Allied Health Clinicians' Uptake of Evidence in Stroke Rehabilitation: A Systematic Review of Determinants Targeted in Implementation Studies. Arch Phys Med Rehabil 2024; 105:988-999. [PMID: 37666287 DOI: 10.1016/j.apmr.2023.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE This study aimed to determine whether targeting specific implementation determinants is associated with allied health clinicians' uptake of evidence when implemented within stroke rehabilitation settings. DATA SOURCES 7 key databases were searched to identify articles published between 1990 and 2022 for inclusion. Reference lists of relevant articles were hand searched. STUDY SELECTION Studies were independently screened by 2 authors and included if the implementation intervention targeted allied health clinical practice in any stroke rehabilitation context and reported at least 1 quantitative measure of evidence uptake. Thirty studies met inclusion criteria. DATA EXTRACTION Data were independently extracted by the first and second author. Implementation outcomes for each study were categorized as either mostly successful, partially successful, or not successful based on the degree of evidence uptake achieved. Determinants targeted were categorized using the Consolidated Framework for Implementation Research (CFIR). DATA SYNTHESIS Patterns between the degree of evidence uptake and determinants targeted across studies were analyzed by the first and second authors in 1 of 3 groups: A (pre-post statistical analysis), B (pre-post descriptive analysis), or C (post-only descriptive analysis). Patterns between evidence uptake and determinants targeted were first identified within groups A and B, with group C consulted to support findings. All studies categorized as "mostly successful" targeted facilitation in combination with establishing face-to-face networks and communication strategies. Conversely, no studies rated "not successful" targeted either of these determinants. Studies rated "partially successful" targeted either 1, but seldom both, of these determinants. CONCLUSIONS This review has provided descriptive evidence of determinants which may be important to target for allied health clinicians' uptake of evidence within stroke rehabilitation settings.
Collapse
Affiliation(s)
- Rachel Levine
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia; STARS Education and Research Alliance, The University of Queensland and Metro North Health, Queensland, Australia.
| | - Sally Zingelman
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia; STARS Education and Research Alliance, The University of Queensland and Metro North Health, Queensland, Australia
| | - Marie-Pier McSween
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia; STARS Education and Research Alliance, The University of Queensland and Metro North Health, Queensland, Australia
| | - Kirstine Shrubsole
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia; STARS Education and Research Alliance, The University of Queensland and Metro North Health, Queensland, Australia; Faculty of Health, Southern Cross University, Bilinga, Queensland Australia
| | - Annie Jane Hill
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia; STARS Education and Research Alliance, The University of Queensland and Metro North Health, Queensland, Australia
| | - David A Copland
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia; STARS Education and Research Alliance, The University of Queensland and Metro North Health, Queensland, Australia
| |
Collapse
|
2
|
Tse T, Skorik S, Fraser R, Munro A, Darzins S. Testing feasibility of relevant outcome measures in an inpatient setting to demonstrate the value of occupational therapy. Aust Occup Ther J 2024; 71:226-239. [PMID: 38058208 DOI: 10.1111/1440-1630.12920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/02/2023] [Accepted: 11/12/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Measures of participation restrictions in daily life occupations are not typically used and may aid discharge planning and demonstrate the impact of occupational therapy services in inpatient settings. The overall aim of this mixed-methods study was to test the feasibility of relevant outcome measures by (1) investigating which of the three identified measures-the Home Support Needs Assessment, the Personal Care Participation Assessment and Resource Tool, and the Functional Autonomy Measurement System-best identifies meaningful changes in participation restrictions in daily life occupations required for community life; and (2) investigating the acceptability, usefulness, and feasibility of each measure to support inpatient practice. METHODS Occupational therapists (n = 3) completed the three measures with patient participants (n = 12) at admission and discharge. Each occupational therapist participated in a semi-structured interview. Outcome measure responses were summarised statistically. Qualitative data were analysed using reflexive thematic analysis. FINDINGS Total scores on all three measures changed significantly between admission and discharge (P < 0.002). Three themes reflected the occupational therapist participants' perceptions of the acceptability, usefulness, and feasibility of the outcome measures: 'Clinically and Professionally Meaningful Tools', 'Becoming Familiar', and 'Fostering My Daily Work'. CONCLUSION Each measure demonstrated a meaningful change. Selection and successful implementation of an outcome measure depends on its local acceptability to occupational therapists and organisational practices. All three measures are promising tools to address a measurement gap in occupational therapy practice. Future research could embed one measure into practice using knowledge translation methods, with a large-scale evaluation of the value of occupational therapy.
Collapse
Affiliation(s)
- Tamara Tse
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Occupational Therapy Department, St Vincent's Hospital, Melbourne, Australia
| | - Stefani Skorik
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Ruby Fraser
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Adrienne Munro
- Occupational Therapy Department, St Vincent's Hospital, Melbourne, Australia
| | - Susan Darzins
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| |
Collapse
|
3
|
Valera-Gran D, Campos-Sánchez I, Prieto-Botella D, Fernández-Pires P, Hurtado-Pomares M, Juárez-Leal I, Peral-Gómez P, Navarrete-Muñoz EM. Enhancing evidence-based practice into healthcare: Exploring the role of scientific skills in occupational therapists. Scand J Occup Ther 2024; 31:2323205. [PMID: 38447524 DOI: 10.1080/11038128.2024.2323205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Research utilization and evidence-based practice (EBP) in occupational therapy rely on essential scientific skills. Despite prior research exploring factors influencing EBP, a gap remains in understanding the specific scientific competencies crucial for effective EBP application. OBJECTIVES To (1) describe the level of scientific skills for EBP and research application, and (2) investigate the factors influencing higher scientific competence among 1159 Spanish-speaking occupational therapists. MATERIAL AND METHODS We assessed the scientific skills using the HACTO-Screen online survey. Recruitment was conducted through a non-probability convenience sampling method between April to June 2020, using social networks and email dissemination to education and professional organizations in Spain and Spanish-speaking Latin American countries. RESULTS Out of a total score of 115 points, participants showed a moderate level of scientific skills (mean: 62.7, SD: 21.6), with literature searching skills ranking the highest and scientific writing skills ranking the lowest. Associations were found between greater scientific competence and advanced degrees, ongoing research training, and on-the-job research. CONCLUSIONS Continuous research training, higher academic degrees, and active research engagement are essential for enhancing scientific competence among occupational therapists. SIGNIFICANCE Targeted training to enhance scientific skills and promote research utilization are crucial in advancing EBP in occupational therapy.
Collapse
Affiliation(s)
- Desirée Valera-Gran
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Irene Campos-Sánchez
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
| | | | - Paula Fernández-Pires
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
- B + D+b Occupational Research Group, Miguel Hernández University, Alicante, Spain
| | - Miriam Hurtado-Pomares
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Iris Juárez-Leal
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Paula Peral-Gómez
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
- B + D+b Occupational Research Group, Miguel Hernández University, Alicante, Spain
| | - Eva María Navarrete-Muñoz
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
- Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| |
Collapse
|
4
|
Jesus TS, Kamalakannan S, Bhattacharjya S, Bettger JP, Jacobs K, Hoenig H. Which factors affect the implementation of telerehabilitation? Study protocol for a mixed-methods systematic review with a framework synthesis. Work 2023:WOR210745. [PMID: 36683522 DOI: 10.3233/wor-210745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Telehealth approaches are promising for the delivery of rehabilitation services but may be under-used or under-implemented. OBJECTIVE To report a review protocol to identify how much telerehabilitation (telehealth approaches to the delivery of rehabilitation services) have been used and implemented, and which factors have affected such implementation. METHODS A mixed-methods systematic review with a framework synthesis. Six databases for the scientific literature will be searched, complemented by snowballing searches and additional references coming from key informants (i.e., rehabilitation researchers from a networking group in health services research). We will include English-language empirical research examining the routine use or implementation of telehealth technologies in physical rehabilitation services or by physical rehabilitation professionals from a range of study designs, excepting case studies, case reports, and qualitative studies with n < 5. Two independent reviewers will perform the screenings, quality appraisals (using the Joanna Briggs Institutes' appraisal checklists), and the data extractions. The Consolidated Framework for Implementation Research will be used to synthesize the data on the enablers and barriers of the implementation of telerehabilitation approaches. All the authors will be involved at this synthesis, and key informants will provide feedback. CONCLUSION The results can inform further implementation endeavours.
Collapse
Affiliation(s)
- Tiago S Jesus
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sureshkumar Kamalakannan
- Public Health Foundation of India (PHFI), South Asia Centre for Disability Inclusive Development and Research (SACDIR), Indian Institute of Public Health - Hyderabad (IIPH-H), Hyderabad, India
| | - Sutanuka Bhattacharjya
- Department of Occupational Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | | | - Karen Jacobs
- Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC, USA.,Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
5
|
Sirgo G, Olona M, Martín-Delgado MC, Gordo F, Trenado J, García M, Bodí M. Cross-cultural adaptation of the SCORE survey and evaluation of the impact of Real-Time Random Safety Audits in organizational culture: A multicenter study. Med Intensiva 2022; 46:568-576. [PMID: 36155679 DOI: 10.1016/j.medine.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/20/2021] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To establish a cross-cultural adaptation of the Safety, Communication, Operational Reliability, and Engagement (SCORE) survey and to use this instrument to evaluate the impact of a safety intervention. DESIGN Cross-cultural adaptation and before-and-after evaluation study. SETTING 5 ICU. PARTICIPANTS Medical residents, attending physicians, and nurses at those ICU. INTERVENTIONS Adaptation of the SCORE survey to Spanish culture. The adapted survey was used to assess all safety-culture-related domains before and one-year after implementing the use of a safety tool, Real-Time Random Safety Audits (in Spanish: Análisis Aleatorios de Seguridad en Tiempo Real, AASTRE). MAIN OUTCOME MEASURE Adaptabiliy of the Spanish version of SCORE survey in the ICU setting and evaluation of the effect of AASTRE on their domains. RESULTS The cross-cultural adaptation was adequate. Post-AASTRE survey scores [mean (standard deviation, SD)] were significantly better in the domains learning environment [50.55 (SD 20.62) vs 60.76 (SD 23.66), p<.0001], perception of local leadership [47.98 (SD 23.57) vs 62.82 (SD 27.46), p<.0001], teamwork climate [51.19 (SD 18.55) vs 55.89 (SD 20.25), p=.031], safety climate [45.07 (SD 17.60) vs 50.36 (SD 19.65), p=.01], participation decision making [3 (SD 0.82) vs 3.65 (SD 0.87), p<.0001] and advancement in the organization [3.21 (SD 0.77) vs 4.04 (SD 0.77), p<.0001]. However, post-AASTRE scores were significantly worse in the domains workload and burnout climate. CONCLUSIONS The cross-cultural adaptation of the SCORE survey into Spanish is a useful tool for ICUs. The application of the AASTRE is associated with improvements in six SCORE domains, including the safety climate.
Collapse
Affiliation(s)
- G Sirgo
- Intensive Care Unit, University Hospital Joan XXIII, Pere Virgili Institute for Health Research, Rovira i Virgili University, Tarragona, Spain.
| | - M Olona
- Department of Preventive Medicine, University Hospital Joan XXIII, Rovira i Virgili University, Tarragona, Spain
| | - M C Martín-Delgado
- Intensive Care Unit, University Hospital Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - F Gordo
- Intensive Care Unit, University Hospital Henares, Coslada, Madrid, Spain
| | - J Trenado
- Intensive Care Unit, University Hospital Mutua de Terrasa, Terrasa, Barcelona , Spain
| | - M García
- Intensive Care Unit, University Hospital Río Ortega, Valladolid, Spain
| | - M Bodí
- Intensive Care Unit, University Hospital Joan XXIII, Pere Virgili Institute for Health Research, Rovira i Virgili University, Tarragona, Spain
| |
Collapse
|
6
|
Romero-Ayuso D, Ortiz-Rubio A, Moreno-Ramírez P, Martín-Martín L, Triviño-Juárez JM, Serrano-Guzmán M, Cano-Detell E, Novoa-Casasola E, Gea M, Ariza-Vega P. A New Tool for Assessment of Professional Skills of Occupational Therapy Students. Healthcare (Basel) 2021; 9:healthcare9101243. [PMID: 34682923 PMCID: PMC8535573 DOI: 10.3390/healthcare9101243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/17/2021] [Accepted: 09/19/2021] [Indexed: 11/24/2022] Open
Abstract
The assessment of the acquisition of professional skills is an essential process in occupational therapy students. Until now, there has been no standardized and validated instrument for evaluating these skills in Spanish occupational therapy students. This study reports the development and testing of the psychometric properties of the professional skills in students of occupational therapy during their practical training. Methods: A new instrument was developed to assess the professional skills of occupational therapy students, called CPTO. A total of 69 occupational therapists participated in evaluating 295 occupational therapy students from the University of Granada, between the 2018 and 2021 academic years. Results: Of a total of 79 items, the factor analysis yielded a final solution of 33 items, which explains 70.22% of the variance with the following three dimensions: (1) self-appraisal and professional responsibility (α = 0.951); (2) communication skills and delivering intervention (α = 0.944); and (3) clinical reasoning for assessing and planning the intervention (α = 0.947). The instrument allows students with low, medium, high and excellent clinical skills to be differentiated according to the cutting points established by the quartiles. Conclusion: the instrument has good psychometric properties, and is a useful tool to assess professional competencies in occupational therapy students during their practice placement education.
Collapse
Affiliation(s)
- Dulce Romero-Ayuso
- Department of Physical Therapy, Occupational Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.O.-R.); (P.M.-R.); (L.M.-M.); (M.S.-G.); (E.C.-D.); (E.N.-C.)
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
- Correspondence: (D.R.-A.); (P.A.-V.)
| | - Araceli Ortiz-Rubio
- Department of Physical Therapy, Occupational Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.O.-R.); (P.M.-R.); (L.M.-M.); (M.S.-G.); (E.C.-D.); (E.N.-C.)
| | - Paz Moreno-Ramírez
- Department of Physical Therapy, Occupational Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.O.-R.); (P.M.-R.); (L.M.-M.); (M.S.-G.); (E.C.-D.); (E.N.-C.)
| | - Lydia Martín-Martín
- Department of Physical Therapy, Occupational Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.O.-R.); (P.M.-R.); (L.M.-M.); (M.S.-G.); (E.C.-D.); (E.N.-C.)
| | - José Matías Triviño-Juárez
- Primary Care Center Zaidín Center-East, Andalusian Health Service, 18006 Granada, Spain;
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain
| | - María Serrano-Guzmán
- Department of Physical Therapy, Occupational Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.O.-R.); (P.M.-R.); (L.M.-M.); (M.S.-G.); (E.C.-D.); (E.N.-C.)
| | - Enrique Cano-Detell
- Department of Physical Therapy, Occupational Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.O.-R.); (P.M.-R.); (L.M.-M.); (M.S.-G.); (E.C.-D.); (E.N.-C.)
| | - Erika Novoa-Casasola
- Department of Physical Therapy, Occupational Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.O.-R.); (P.M.-R.); (L.M.-M.); (M.S.-G.); (E.C.-D.); (E.N.-C.)
| | - Miguel Gea
- Department of Computer Systems, Computer Sciences, University of Granada, 18014 Granada, Spain;
| | - Patrocinio Ariza-Vega
- Department of Physical Therapy, Occupational Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (A.O.-R.); (P.M.-R.); (L.M.-M.); (M.S.-G.); (E.C.-D.); (E.N.-C.)
- Correspondence: (D.R.-A.); (P.A.-V.)
| |
Collapse
|
7
|
Celian C, Swanson V, Shah M, Newman C, Fowler-King B, Gallik S, Reilly K, Reinkensmeyer DJ, Patton J, Rafferty MR. A day in the life: a qualitative study of clinical decision-making and uptake of neurorehabilitation technology. J Neuroeng Rehabil 2021; 18:121. [PMID: 34321036 PMCID: PMC8317366 DOI: 10.1186/s12984-021-00911-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/15/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Neurorehabilitation engineering faces numerous challenges to translating new technologies, but it is unclear which of these challenges are most limiting. Our aim is to improve understanding of rehabilitation therapists' real-time decision-making processes on the use of rehabilitation technology (RT) in clinical treatment. METHODS We used a phenomenological qualitative approach, in which three OTs and two PTs employed at a major, technology-encouraging rehabilitation hospital wrote vignettes from a written prompt describing their RT use decisions during treatment sessions with nine patients (4 with stroke, 2 traumatic brain injury, 1 spinal cord injury, 1 with multiple sclerosis). We then coded the vignettes using deductive qualitative analysis from 17 constructs derived from the RT literature and the Consolidated Framework for Implementation Research (CFIR). Data were synthesized using summative content analysis. RESULTS Of the constructs recorded, the five most prominent are from CFIR determinants of: (i) relative advantage, (ii) personal attributes of the patients, (iii) clinician knowledge and beliefs of the device/intervention, (iv) complexity of the devices including time and setup, and (v) organizational readiness to implement. Therapists characterized candidate RT as having a relative disadvantage compared to conventional treatment due to lack of relevance to functional training. RT design also often failed to consider the multi-faceted personal attributes of the patients, including diagnoses, goals, and physical and cognitive limitations. Clinicians' comfort with RT was increased by their previous training but was decreased by the perceived complexity of RT. Finally, therapists have limited time to gather, setup, and use RT. CONCLUSIONS Despite decades of design work aimed at creating clinically useful RT, many lack compatibility with clinical translation needs in inpatient neurologic rehabilitation. New RT continue to impede the immediacy, versatility, and functionality of hands-on therapy mediated treatment with simple everyday objects.
Collapse
Affiliation(s)
- Courtney Celian
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Veronica Swanson
- Department of Mechanical and Aerospace Engineering, Henry Samueli School of Engineering, University of California, Engineering Gateway 4200, Irvine, CA, 92697, USA
| | - Maahi Shah
- Department of Bioengineering, University of Illinois at Chicago, 851 S Morgan St, Chicago, IL, 60607, USA
| | - Caitlin Newman
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | | | - Sarah Gallik
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - Kaitlin Reilly
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
| | - David J Reinkensmeyer
- Department of Mechanical and Aerospace Engineering, Henry Samueli School of Engineering, University of California, Engineering Gateway 4200, Irvine, CA, 92697, USA
- Department of Anatomy and Neurobiology, UC Irvine School of Medicine, University of California, Irvine, Irvine, CA, 92617, USA
| | - James Patton
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA
- Department of Bioengineering, University of Illinois at Chicago, 851 S Morgan St, Chicago, IL, 60607, USA
| | - Miriam R Rafferty
- Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA.
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL, 60611, USA.
| |
Collapse
|
8
|
Sirgo G, Olona M, Martín-Delgado MC, Gordo F, Trenado J, García M, Bodí M. Cross-cultural adaptation of the SCORE survey and evaluation of the impact of Real-Time Random Safety Audits in organizational culture: A multicenter study. Med Intensiva 2021; 46:S0210-5691(21)00074-7. [PMID: 34052044 DOI: 10.1016/j.medin.2021.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/09/2021] [Accepted: 03/20/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To establish a cross-cultural adaptation of the Safety, Communication, Operational Reliability, and Engagement (SCORE) survey and to use this instrument to evaluate the impact of a safety intervention. DESIGN Cross-cultural adaptation and before-and-after evaluation study. SETTING 5 ICU. PARTICIPANTS Medical residents, attending physicians, and nurses at those ICU. INTERVENTIONS Adaptation of the SCORE survey to Spanish culture. The adapted survey was used to assess all safety-culture-related domains before and one-year after implementing the use of a safety tool, Real-Time Random Safety Audits (in Spanish: Análisis Aleatorios de Seguridad en Tiempo Real, AASTRE). MAIN OUTCOME MEASURE Adaptabiliy of the Spanish version of SCORE survey in the ICU setting and evaluation of the effect of AASTRE on their domains. RESULTS The cross-cultural adaptation was adequate. Post-AASTRE survey scores [mean (standard deviation, SD)] were significantly better in the domains learning environment [50.55 (SD 20.62) vs 60.76 (SD 23.66), p<.0001], perception of local leadership [47.98 (SD 23.57) vs 62.82 (SD 27.46), p<.0001], teamwork climate [51.19 (SD 18.55) vs 55.89 (SD 20.25), p=.031], safety climate [45.07 (SD 17.60) vs 50.36 (SD 19.65), p=.01], participation decision making [3 (SD 0.82) vs 3.65 (SD 0.87), p<.0001] and advancement in the organization [3.21 (SD 0.77) vs 4.04 (SD 0.77), p<.0001]. However, post-AASTRE scores were significantly worse in the domains workload and burnout climate. CONCLUSIONS The cross-cultural adaptation of the SCORE survey into Spanish is a useful tool for ICUs. The application of the AASTRE is associated with improvements in six SCORE domains, including the safety climate.
Collapse
Affiliation(s)
- G Sirgo
- Intensive Care Unit, University Hospital Joan XXIII, Pere Virgili Institute for Health Research, Rovira i Virgili University, Tarragona, Spain.
| | - M Olona
- Department of Preventive Medicine, University Hospital Joan XXIII, Rovira i Virgili University, Tarragona, Spain
| | - M C Martín-Delgado
- Intensive Care Unit, University Hospital Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - F Gordo
- Intensive Care Unit, University Hospital Henares, Coslada, Madrid, Spain
| | - J Trenado
- Intensive Care Unit, University Hospital Mutua de Terrasa, Terrasa, Barcelona , Spain
| | - M García
- Intensive Care Unit, University Hospital Río Ortega, Valladolid, Spain
| | - M Bodí
- Intensive Care Unit, University Hospital Joan XXIII, Pere Virgili Institute for Health Research, Rovira i Virgili University, Tarragona, Spain
| |
Collapse
|
9
|
Piat M, Wainwright M, Sofouli E, Vachon B, Deslauriers T, Préfontaine C, Frati F. Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review. Syst Rev 2021; 10:134. [PMID: 33952336 PMCID: PMC8101029 DOI: 10.1186/s13643-021-01646-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 03/22/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Countries around the world have committed in policy to transforming their mental health services towards a recovery orientation. How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services? METHODS This systematic mixed studies review followed a convergent qualitative synthesis design and used the best-fit framework synthesis method. Librarians ran searches in Ovid- MEDLINE, Ovid-EMBASE, Ovid-PsycInfo, EBSCO-CINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus. Two reviewers independently screened studies for inclusion or exclusion using DistillerSR. Qualitative, quantitative, and mixed methods peer-reviewed studies published since 1998 were included if they reported a new effort to transform adult mental health services towards a recovery orientation, and reported findings related to implementation experience, process, or factors. Data was extracted in NVivo12 to the 38 constructs of the Consolidated Framework for Implementation Research (CFIR). The synthesis included a within-case and a cross-case thematic analysis of data coded to each CFIR construct. Cases were types of recovery-oriented innovations. RESULTS Seventy studies met our inclusion criteria. These were grouped into seven types of recovery-oriented innovations (cases) for within-case and cross-case synthesis. Themes illustrating common implementation factors across innovations are presented by CFIR domain: Intervention Characteristics (flexibility, relationship building, lived experience); Inner Setting (traditional biomedical vs. recovery-oriented approach, the importance of organizational and policy commitment to recovery-transformation, staff turnover, lack of resources to support personal recovery goals, information gaps about new roles and procedures, interpersonal relationships), Characteristics of Individuals (variability in knowledge about recovery, characteristics of recovery-oriented service providers); Process (the importance of planning, early and continuous engagement with stakeholders). Very little data from included studies was extracted to the outer setting domain, and therefore, we present only some initial observations and note that further research on outer setting implementation factors is needed. CONCLUSION The CFIR required some adaptation for use as an implementation framework in this review. The common implementation factors presented are an important starting point for stakeholders to consider when implementing recovery-oriented services.
Collapse
Affiliation(s)
- Myra Piat
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada. .,McGill University, Québec, Canada.
| | - Megan Wainwright
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada.,Department of Anthropology, Durham University, Durham, Canada
| | - Eleni Sofouli
- Douglas Mental Health University Institute, 6875, boul. LaSalle, Montréal, Québec, H4H 1R3, Canada.,McGill University, Québec, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Université de Montréal, C.P. 6128, succursale Centre-ville, Montreal, Québec, H3C 3J7, Canada
| | - Tania Deslauriers
- School of Rehabilitation, Université de Montréal, 7077 avenue du Parc, Montreal, QC, H3N 1X7, Canada
| | - Cassandra Préfontaine
- Université du Québec à Trois-Rivières, 3351 Boulevard des Forges, Trois-Rivières, QC, G8Z 4M3, Canada
| | - Francesca Frati
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, 809, Sherbrooke W, Montreal, Québec, H3A 0C9, Canada
| |
Collapse
|
10
|
Connell LA, Chesworth B, Ackerley S, Smith MC, Stinear CM. Implementing the PREP2 Algorithm to Predict Upper Limb Recovery Potential After Stroke in Clinical Practice: A Qualitative Study. Phys Ther 2021; 101:6124112. [PMID: 33522586 DOI: 10.1093/ptj/pzab040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 09/17/2020] [Accepted: 12/28/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Predicting motor recovery after stroke is a key factor when planning and providing rehabilitation for individual patients. The Predict REcovery Potential (PREP2) prediction tool was developed to help clinicians predict upper limb functional outcome. In parallel to further model validation, the purpose of this study was to explore how PREP2 was implemented in clinical practice within the Auckland District Health Board (ADHB) in New Zealand. METHODS In this case study design using semi-structured interviews, 19 interviews were conducted with clinicians involved in stroke care at ADHB. To explore factors influencing implementation, interview content was coded and analyzed using the consolidated framework for implementation research. Strategies identified by the Expert Recommendations for Implementing Change Project were used to describe how implementation was undertaken. RESULTS Implementation of PREP2 was initiated and driven by therapists. Key factors driving implementation were as follows: the support given to staff from the implementation team; the knowledge, beliefs, and self-efficacy of staff; and the perceived benefits of having PREP2 prediction information. Twenty-six Expert Recommendations for Implementing Change strategies were identified relating to 3 areas: implementation team, clinical/academic partnerships, and training. CONCLUSIONS The PREP2 prediction tool was successfully implemented in clinical practice at ADHB. Barriers and facilitators to implementation success were identified, and implementation strategies were described. Lessons learned can aid future development and implementation of prediction models in clinical practice. IMPACT Translating evidence-based interventions into clinical practice can be challenging and slow; however, shortly after its local validation, PREP2 was successfully implemented into clinical practice at the same site in New Zealand. In parallel to further model validation, organizations and practices can glean useful lessons to aid future implementation.
Collapse
Affiliation(s)
- Louise A Connell
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, Lancashire, United Kingdom.,East Lancashire Hospitals NHS Trust, Blackburn, United Kingdom
| | - Brigit Chesworth
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Suzanne Ackerley
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Marie-Claire Smith
- Department of Medicine, University of Auckland, Auckland, New Zealand.,Allied Health, Auckland District Health Board, Auckland, New Zealand
| | - Cathy M Stinear
- Department of Medicine, University of Auckland, Auckland, New Zealand
| |
Collapse
|
11
|
Barriers and facilitators for implementation of a patient prioritization tool in two specialized rehabilitation programs. JBI Evid Implement 2021; 19:149-161. [PMID: 33843768 DOI: 10.1097/xeb.0000000000000281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIMS Prioritization tools aim to manage access to care by ranking patients equitably in waiting lists based on determined criteria. Patient prioritization has been studied in a wide variety of clinical health services, including rehabilitation contexts. We created a web-based patient prioritization tool (PPT) with the participation of stakeholders in two rehabilitation programs, which we aim to implement into clinical practice. Successful implementation of such innovation can be influenced by a variety of determinants. The goal of this study was to explore facilitators and barriers to the implementation of a PPT in rehabilitation programs. METHODS We used two questionnaires and conducted two focus groups among service providers from two rehabilitation programs. We used descriptive statistics to report results of the questionnaires and qualitative content analysis based on the Consolidated Framework for Implementation Research. RESULTS Key facilitators are the flexibility and relative advantage of the tool to improve clinical practices and produce beneficial outcomes for patients. Main barriers are the lack of training, financial support and human resources to sustain the implementation process. CONCLUSION This is the first study that highlights organizational, individual and innovation levels facilitators and barriers for the implementation of a prioritization tool from service providers' perspective.
Collapse
|
12
|
Screening for Scientific Skills in Spanish-Speaking Occupational Therapists (HACTO-Screen): Study Protocol of a Cross-Sectional Survey. Healthcare (Basel) 2021; 9:healthcare9020124. [PMID: 33530629 PMCID: PMC7912390 DOI: 10.3390/healthcare9020124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/22/2020] [Accepted: 01/21/2021] [Indexed: 11/17/2022] Open
Abstract
The acquisition of scientific competencies for the application of evidence-based practice (EBP) is considered an essential part of healthcare education programs in order to improve clinical effectiveness. An examination of scientific skills in occupational therapists may be helpful in understanding their current practice as well as being useful in providing a basis for applying suitable approaches to the development and implementation of EBP. Hence, this study was designed with a double main objective: (1) to describe the level of acquisition of scientific skills and academic achievement in Spanish-speaking occupational therapists; (2) to examine the factors associated with these skills. The screening for Scientific Skills in Occupational Therapists (HAbilidades Científicas en Terapeutas Ocupacionales), the HACTO-Screen, is an online cross-sectional survey divided into five sections: sociodemographic data, academic and professional background; assessment of scientific skills; research training and development needs; experience as a researcher and/or academic. A total sample of 1159 occupational therapists finally participated. Main associations will be analyzed using multiple linear and/or Poisson regression models with/without robust variance. Our findings will provide valuable insights on the research skills and associated factors in a large sample of Spanish-speaking occupational therapists. The results will also be helpful to enhance research training and research career development in occupational therapy in order to promote the use of EBP.
Collapse
|
13
|
Translating Evidence Into Practice Through Knowledge Implementation. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|