Abstract
Objective
To characterize the peer-reviewed quality improvement (QI) literature in rehabilitation.
Data Sources
Five electronic databases were searched for English-language articles from 2010 to
2016. Keywords for QI and safety management were searched for in combination with
keywords for rehabilitation content and journals. Secondary searches (eg, references-list
scanning) were also performed.
Study Selection
Two reviewers independently selected articles using working definitions of rehabilitation
and QI study types; of 1016 references, 112 full texts were assessed for eligibility.
Data Extraction
Reported study characteristics including study focus, study setting, use of inferential
statistics, stated limitations, and use of improvement cycles and theoretical models
were extracted by 1 reviewer, with a second reviewer consulted whenever inferences
or interpretation were involved.
Data Synthesis
Fifty-nine empirical rehabilitation QI studies were found: 43 reporting on local QI
activities, 7 reporting on QI effectiveness research, 8 reporting on QI facilitators
or barriers, and 1 systematic review of a specific topic. The number of publications
had significant yearly growth between 2010 and 2016 (P=.03). Among the 43 reports on local QI activities, 23.3% did not explicitly report
any study limitations; 39.5% did not used inferential statistics to measure the QI
impact; 95.3% did not cite/mention the appropriate reporting guidelines; only 18.6%
reported multiple QI cycles; just over 50% reported using a model to guide the QI
activity; and only 7% reported the use of a particular theoretical model. Study sites
and focuses were diverse; however, nearly a third (30.2%) examined early mobilization
in intensive care units.
Conclusions
The number of empirical, peer-reviewed rehabilitation QI publications is growing but
remains a tiny fraction of rehabilitation research publications. Rehabilitation QI
studies could be strengthened by greater use of extant models and theory to guide
the QI work, consistent reporting of study limitations, and use of inferential statistics.
Keywords
List of abbreviations:
ICU (intensive care unit), IRB (institutional review board), PT (physical therapy), QI (quality improvement), SQUIRE (Standards for QUality Improvement Reporting Excellence)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 28, 2017
Footnotes
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
