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Original research| Volume 99, ISSUE 1, P82-90, January 2018

Development, Implementation, and Use of a Process to Promote Knowledge Translation in Rehabilitation

Published:September 16, 2017DOI:https://doi.org/10.1016/j.apmr.2017.08.476

      Abstract

      Objective

      To examine the use and effect of the Battery of Rehabilitation Assessments and Interventions on evidence-based practice (EBP) over 6 years.

      Design

      Successive independent samples study.

      Setting

      Large rehabilitation system.

      Participants

      Successive samples of allied health clinicians (N=372) in 2009 (n=136), 2012 (n=115), and 2015 (n=121).

      Interventions

      The Battery of Rehabilitation Assessments and Interventions includes 2 components: (1) a process to synthesize, adapt, and make recommendations about the application of evidence; and (2) a process to implement the recommended practices in 3 levels of care.

      Main Outcome Measures

      To assess the effect of the project, surveys on EBP perspectives, use, and barriers were conducted before Battery of Rehabilitation Assessments and Interventions implementation and 3 and 6 years after implementation. Questions about effect of the project on clinical practice were included 3 and 6 years postimplementation.

      Results

      Survey data indicate the Battery of Rehabilitation Assessments and Interventions resulted in a significant increase in use of EBPs to make clinical decisions and justify care. As a result of the project, survey participants reported a substantial increase in use of outcome measures in 2012 (74%) and 2015 (91%) and evidence-based interventions in 2012 (62%) and 2015 (82%). In 2012, significant differences (P≤.01) in effect of the Battery of Rehabilitation Assessments and Interventions on practice were identified between therapists who were directly involved in the project and Interventions compared with uninvolved therapists. In 2015, no significant differences existed between involved and uninvolved therapists.

      Conclusions

      After 6 years of sustained implementation efforts, the Battery of Rehabilitation Assessments and Interventions expedited the adoption of EBPs throughout a large system of care in rehabilitation.

      Keywords

      List of abbreviations:

      EBP (evidence-based practice), KT (knowledge translation), RIC (Rehabilitation Institute of Chicago)
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      References

        • Morris Z.S.
        • Wooding S.
        • Grant J.
        The answer is 17 years, what is the question: understanding time lags in translational research.
        J R Soc Med. 2011; 104: 510-520
        • Straus S.E.
        • Tetroe J.
        • Graham I.
        Defining knowledge translation.
        CMAJ. 2009; 181: 165-168
        • Williams B.
        • Perillo S.
        • Brown T.
        What are the factors of organisational culture in health care settings that act as barriers to the implementation of evidence-based practice? A scoping review.
        Nurse Educ Today. 2015; 35: e34-e41
        • Harlos K.
        • Tetroe J.
        • Graham I.D.
        • Bird M.
        • Robinson N.
        Mining the management literature for insights into implementing evidence-based change in healthcare.
        Healthc Policy. 2012; 8: 33-48
        • Green L.A.
        • Gorenflo D.W.
        • Wyszewianski L.
        Validating an instrument for selecting interventions to change physician practice patterns: a Michigan Consortium for Family Practice Research study.
        J Fam Pract. 2002; 51: 938-942
        • Jette D.U.
        • Bacon K.
        • Batty C.
        • et al.
        Evidence-based practice: beliefs, attitudes, knowledge, and behaviors of physical therapists.
        Phys Ther. 2003; 83: 786-805
        • Philibert D.B.
        • Snyder P.
        • Judd D.
        • Windsor M.M.
        Practitioners' reading patterns, attitudes, and use of research reported in occupational therapy journals.
        Am J Occup Ther. 2003; 57: 450-458
        • Zipoli Jr., R.P.
        • Kennedy M.
        Evidence-based practice among speech-language pathologists: attitudes, utilization, and barriers.
        Am J Speech Lang Pathol. 2005; 14: 208-220
        • Lang C.E.
        • Macdonald J.R.
        • Reisman D.S.
        • et al.
        Observation of amounts of movement practice provided during stroke rehabilitation.
        Arch Phys Med Rehabil. 2009; 90: 1692-1698
        • Moore J.L.
        • Roth E.J.
        • Killian C.
        • Hornby T.G.
        Locomotor training improves daily stepping activity and gait efficiency in individuals poststroke who have reached a “plateau” in recovery.
        Stroke. 2010; 41: 129-135
        • Heiwe S.
        • Kajermo K.N.
        • Tyni-Lenne R.
        • et al.
        Evidence-based practice: attitudes, knowledge and behaviour among allied health care professionals.
        Int J Qual Health Care. 2011; 23: 198-209
        • Salbach N.M.
        • Jaglal S.B.
        • Korner-Bitensky N.
        • Rappolt S.
        • Davis D.
        Practitioner and organizational barriers to evidence-based practice of physical therapists for people with stroke.
        Phys Ther. 2007; 87: 1284-1303
        • Salbach N.M.
        • Guilcher S.J.
        • Jaglal S.B.
        • Davis D.A.
        Determinants of research use in clinical decision making among physical therapists providing services post-stroke: a cross-sectional study.
        Implement Sci. 2010; 5: 77
        • Bernhardsson S.
        • Johansson K.
        • Nilsen P.
        • Oberg B.
        • Larsson M.E.
        Determinants of guideline use in primary care physical therapy: a cross-sectional survey of attitudes, knowledge, and behavior.
        Phys Ther. 2014; 94: 343-354
        • Nilsen P.
        Making sense of implementation theories, models and frameworks.
        Implement Sci. 2015; 10: 53
        • Hudon A.
        • Gervais M.J.
        • Hunt M.
        The contribution of conceptual frameworks to knowledge translation interventions in physical therapy.
        Phys Ther. 2015; 95: 630-639
        • Levac D.
        • Glegg S.M.
        • Camden C.
        • Rivard L.M.
        • Missiuna C.
        Best practice recommendations for the development, implementation, and evaluation of online knowledge translation resources in rehabilitation.
        Phys Ther. 2015; 95: 648-662
        • Zidarov D.
        • Thomas A.
        • Poissant L.
        Knowledge translation in physical therapy: from theory to practice.
        Disabil Rehabil. 2013; 35: 1571-1577
        • Field B.
        • Booth A.
        • Ilott I.
        • Gerrish K.
        Using the knowledge to action framework in practice: a citation analysis and systematic review.
        Implement Sci. 2014; 9: 172
        • Straus S.
        • Tetroe J.
        • Graham I.
        Knowledge translation in health care: moving from evidence to practice.
        2nd ed. BMJ Books, West Sussex2013
        • Graham I.D.
        • Logan J.
        • Harrison M.B.
        • et al.
        Lost in knowledge translation: time for a map?.
        J Contin Educ Health Prof. 2006; 26: 13-24
        • Kastner M.
        • Straus S.E.
        Application of the knowledge-to-action and Medical Research Council frameworks in the development of an osteoporosis clinical decision support tool.
        J Clin Epidemiol. 2012; 65: 1163-1170
        • Straus S.
        • Tetroe J.
        • Graham I.
        Knowledge Translation in Health Care: Moving from Evidence to Practice, 2nd edition.
        BMJ Books, West Sussex, UK2013
        • ALMohiza M.
        • Sparto P.
        • Marchetti G.
        • et al.
        A quality improvement project in balance and vestibular rehabilitation and its effect on clinical outcome measures.
        J Neurol Physical Ther. 2016; 40: 90-99
        • Schreiber J.
        • Marchetti G.F.
        • Racicot B.
        • Kaminski E.
        The use of a knowledge translation program to increase use of standardized outcome measures in an outpatient pediatric physical therapy clinic: administrative case report.
        Phys Ther. 2015; 95: 613-629
        • Jones C.A.
        • Roop S.C.
        • Pohar S.L.
        • Albrecht L.
        • Scott S.D.
        Translating knowledge in rehabilitation: systematic review.
        Phys Ther. 2015; 95: 663-677
        • Perry S.B.
        • Zeleznik H.
        • Breisinger T.
        Supporting clinical practice behavior change among neurologic physical therapists: a case study in knowledge translation.
        J Neurol Phys Ther. 2014; 38: 134-143
        • Stevans J.M.
        • Bise C.G.
        • McGee J.C.
        • Miller D.L.
        • Rockar Jr., P.
        • Delitto A.
        Evidence-based practice implementation: case report of the evolution of a quality improvement program in a multicenter physical therapy organization.
        Phys Ther. 2015; 95: 588-599
        • Cunningham J.
        • Wallston K.A.
        • Wilkins C.H.
        • Hull P.C.
        • Miller S.T.
        Development and psychometric evaluation of the HPV Clinical Trial Survey for Parents (CTSP-HPV) using traditional survey development methods and community engagement principles.
        Clin Transl Sci. 2015; 8: 702-709
        • Esrailian E.
        • Spiegel B.M.
        • Targownik L.E.
        • Dubinsky M.C.
        • Targan S.R.
        • Gralnek I.M.
        Differences in the management of Crohn's disease among experts and community providers, based on a national survey of sample case vignettes.
        Aliment Pharmacol Ther. 2007; 26: 1005-1018
        • Akins R.B.
        • Tolson H.
        • Cole B.R.
        Stability of response characteristics of a Delphi panel: application of bootstrap data expansion.
        BMC Med Res Methodol. 2005; 5: 37
        • Moore J.L.
        • Raad J.
        • Ehrlich-Jones L.
        • Heinemann A.W.
        Development and use of a knowledge translation tool: the rehabilitation measures database.
        Arch Phys Med Rehabil. 2014; 95: 197-202
        • Camden C.
        • Shikako-Thomas K.
        • Nguyen T.
        • et al.
        Engaging stakeholders in rehabilitation research: a scoping review of strategies used in partnerships and evaluation of impacts.
        Disabil Rehabil. 2015; 37: 1390-1400
        • Bowen S.J.
        • Graham I.D.
        From knowledge translation to engaged scholarship: promoting research relevance and utilization.
        Arch Phys Med Rehabil. 2013; 94: S3-S8
        • Rosenbaum P.
        Family-centred research: what does it mean and can we do it?.
        Dev Med Child Neurol. 2011; 53: 99-100
        • Gifford W.A.
        • Davies B.
        • Edwards N.
        • Graham I.D.
        Leadership strategies to influence the use of clinical practice guidelines.
        Nurs Leadersh (Tor Ont). 2006; 19: 72-88