Carol L Richards1,2,3, Francine Malouin1,2,3, Sylvie Nadeau4,5,6, Joyce Fung5,7,8, Line D'Amours1, Claire Perez5,7,8, Anne Durand1. 1. Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City. 2. Centre interdisciplinaire de recherche en réadaptation et intégration sociale. 3. Département de réadaptation, Université Laval, Quebec City, Que. 4. Institut de réadaptation Gingras-Lindsay de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal. 5. Centre interdisciplinaire de recherche en réadaptation. 6. École de réadaptation, Université de Montréal. 7. Jewish Rehabilitation Hospital, Centre intégré de santé et de services sociaux de Laval. 8. School of Physical and Occupational Therapy, McGill University, Montreal.
Abstract
Purpose: This study describes the development of a standardized assessment toolkit (SAT) and associated clinical database focusing on sensorimotor rehabilitation in three stroke rehabilitation units (SRUs). Implementation of the SAT was confirmed using objective measures of clinician adherence while exploring reasons for varied adherence. Method: Participants were patients post-stroke admitted for inpatient rehabilitation and clinicians from the three SRUs. A collaborative and iterative process was used to develop the SAT. Implementation was measured by clinician adherence, which was charted by means of assessment entries in patient records and transferred to the clinical database. Reasons for lower adherence were interpreted from therapist data logs at one SRU. Results: The SAT consisted of 25 assessment tools. Clinician adherence to a subset of the tools ranged from 33% to 99% at admission and from 28% to 94% at discharge. At one site, lower adherence among the tools was explained by patient-related factors (1%-36%) and protocol or logistical reasons (0%-7%) at admission; missing data ranged from 0% to 3%, except for the Montreal Cognitive Assessment (17%). Conclusions: In this pragmatic study, objective measures of clinician adherence demonstrated the feasibility of implementing an SAT in daily practice. Moreover, the reasons for lower adherence rates may be related to the patients, protocol, and logistics, all of which may vary with the assessment tool, rather than clinician compliance.
Purpose: This study describes the development of a standardized assessment toolkit (SAT) and associated clinical database focusing on sensorimotor rehabilitation in three stroke rehabilitation units (SRUs). Implementation of the SAT was confirmed using objective measures of clinician adherence while exploring reasons for varied adherence. Method: Participants were patients post-stroke admitted for inpatient rehabilitation and clinicians from the three SRUs. A collaborative and iterative process was used to develop the SAT. Implementation was measured by clinician adherence, which was charted by means of assessment entries in patient records and transferred to the clinical database. Reasons for lower adherence were interpreted from therapist data logs at one SRU. Results: The SAT consisted of 25 assessment tools. Clinician adherence to a subset of the tools ranged from 33% to 99% at admission and from 28% to 94% at discharge. At one site, lower adherence among the tools was explained by patient-related factors (1%-36%) and protocol or logistical reasons (0%-7%) at admission; missing data ranged from 0% to 3%, except for the Montreal Cognitive Assessment (17%). Conclusions: In this pragmatic study, objective measures of clinician adherence demonstrated the feasibility of implementing an SAT in daily practice. Moreover, the reasons for lower adherence rates may be related to the patients, protocol, and logistics, all of which may vary with the assessment tool, rather than clinician compliance.
Authors: Susan Barreca; Carolyn Kelly Gowland; Paul Stratford; Maria Huijbregts; Jeremy Griffiths; Wendy Torresin; Magen Dunkley; Patricia Miller; Lisa Masters Journal: Top Stroke Rehabil Date: 2004 Impact factor: 2.119
Authors: Pamela W Duncan; Richard Zorowitz; Barbara Bates; John Y Choi; Jonathan J Glasberg; Glenn D Graham; Richard C Katz; Kerri Lamberty; Dean Reker Journal: Stroke Date: 2005-09 Impact factor: 7.914
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: C Gowland; P Stratford; M Ward; J Moreland; W Torresin; S Van Hullenaar; J Sanford; S Barreca; B Vanspall; N Plews Journal: Stroke Date: 1993-01 Impact factor: 7.914
Authors: Carol L Richards; Anne Durand; Francine Malouin; Sylvie Nadeau; Joyce Fung; Line D'Amours; Claire Perez Journal: Physiother Can Date: 2020 Impact factor: 1.037