Jacqui H Morris1, Susanne Bernhardsson2,3, Marie-Louise Bird4, Louise Connell5, Elizabeth Lynch6,7,8, Kathryn Jarvis5, Nicola M Kayes9, Kim Miller10,11, Suzie Mudge9, Rebecca Fisher12. 1. School of Nursing and Health Sciences, University of Dundee, Dundee, UK. 2. Närhälsan Research and Development Primary Health Care, Gothenburg, Sweden. 3. The Sahlgrenska Academy Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden. 4. Department of Physical Therapy, University of British Columbia, Vancouver, Canada. 5. School of Health Sciences, University of Central Lancashire, Preston, UK. 6. Adelaide Nursing School, University of Adelaide, Adelaide, Australia. 7. Stroke Division, The Florey Institute of Neuroscience and Mental Health, Victoria, Australia. 8. NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Victoria, Australia. 9. Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand. 10. Evidence Centre, Sunny Hill Health Centre for Children, Vancouver, Canada. 11. Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada. 12. School of Medicine, University of Nottingham, Nottingham, UK.
Abstract
Purpose: Despite growth in rehabilitation research, implementing research findings into rehabilitation practice has been slow. This creates inequities for patients and is an ethical issue. However, methods to investigate and facilitate evidence implementation are being developed. This paper aims to make these methods relevant and accessible for rehabilitation researchers and practitioners. Methods: Rehabilitation practice is varied and complex and occurs within multilevel healthcare systems. Using a "road map" analogy, we describe how implementation concepts and theories can inform implementation strategies in rehabilitation. The roadmap involves a staged journey that considers: the nature of evidence; context for implementation; navigation tools for implementation; strategies to facilitate implementation; evaluation of implementation outcomes; and sustainability of implementation. We have developed a model to illustrate the journey, and four case studies exemplify implementation stages in rehabilitation settings.Results and Conclusions: Effective implementation strategies for the complex world of rehabilitation are urgently required. The journey we describe unpacks that complexity to provide a template for effective implementation, to facilitate translation of the growing evidence base in rehabilitation into improved patient outcomes. It emphasizes the importance of understanding context and application of relevant theory, and highlights areas which should be targeted in new implementation research in rehabilitation.Implications for rehabilitationEffective implementation of research evidence into rehabilitation practice has many interconnected steps and a roadmap analogy is helpful in defining them.Understanding context for implementation is critically important and using theory can facilitate development of understanding.Research methods for implementation in rehabilitation should be carefully selected and outcomes should evaluate implementation success as well as clinical change.Sustainability requires regular revisiting of the interconnected steps.
Purpose: Despite growth in rehabilitation research, implementing research findings into rehabilitation practice has been slow. This creates inequities for patients and is an ethical issue. However, methods to investigate and facilitate evidence implementation are being developed. This paper aims to make these methods relevant and accessible for rehabilitation researchers and practitioners. Methods: Rehabilitation practice is varied and complex and occurs within multilevel healthcare systems. Using a "road map" analogy, we describe how implementation concepts and theories can inform implementation strategies in rehabilitation. The roadmap involves a staged journey that considers: the nature of evidence; context for implementation; navigation tools for implementation; strategies to facilitate implementation; evaluation of implementation outcomes; and sustainability of implementation. We have developed a model to illustrate the journey, and four case studies exemplify implementation stages in rehabilitation settings.Results and Conclusions: Effective implementation strategies for the complex world of rehabilitation are urgently required. The journey we describe unpacks that complexity to provide a template for effective implementation, to facilitate translation of the growing evidence base in rehabilitation into improved patient outcomes. It emphasizes the importance of understanding context and application of relevant theory, and highlights areas which should be targeted in new implementation research in rehabilitation.Implications for rehabilitationEffective implementation of research evidence into rehabilitation practice has many interconnected steps and a roadmap analogy is helpful in defining them.Understanding context for implementation is critically important and using theory can facilitate development of understanding.Research methods for implementation in rehabilitation should be carefully selected and outcomes should evaluate implementation success as well as clinical change.Sustainability requires regular revisiting of the interconnected steps.
Authors: Jessica Pope Mitro; J Mary Louise Pomeroy; Sarah Osman; Virina Matta; Cindy Cai; Steven Garfinkel; Ali A Weinstein Journal: Rehabil Nurs Date: 2022-03-18 Impact factor: 1.462