Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial
Abstract Background The Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE-IT) was a cluster randomized controlled trial that evaluated two knowledge translation (KT) interventions for the promotion of the uptake of best practice recommendations for interventions ta...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-017-2389-7 |
| _version_ | 1818198025667870720 |
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| author | Sarah E. P. Munce Ian D. Graham Nancy M. Salbach Susan B. Jaglal Carol L. Richards Janice J. Eng Johanne Desrosiers Marilyn MacKay-Lyons Sharon Wood-Dauphinee Nicol Korner-Bitensky Nancy E. Mayo Robert W. Teasell Merrick Zwarenstein Jennifer Mokry Sandra Black Mark T. Bayley |
| author_facet | Sarah E. P. Munce Ian D. Graham Nancy M. Salbach Susan B. Jaglal Carol L. Richards Janice J. Eng Johanne Desrosiers Marilyn MacKay-Lyons Sharon Wood-Dauphinee Nicol Korner-Bitensky Nancy E. Mayo Robert W. Teasell Merrick Zwarenstein Jennifer Mokry Sandra Black Mark T. Bayley |
| author_sort | Sarah E. P. Munce |
| collection | DOAJ |
| description | Abstract Background The Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE-IT) was a cluster randomized controlled trial that evaluated two knowledge translation (KT) interventions for the promotion of the uptake of best practice recommendations for interventions targeting upper and lower extremity function, postural control, and mobility. Twenty rehabilitation centers across Canada were randomly assigned to either the facilitated or passive KT intervention. The objective of the current study was to understand the factors influencing the implementation of the recommended treatments and KT interventions from the perspective of nurses, occupational therapists and physical therapists, and clinical managers following completion of the trial. Methods A qualitative descriptive approach involving focus groups was used. Thematic analysis was used to understand the factors influencing the implementation of the recommended treatments and KT interventions. The Clinical Practice Guidelines Framework for Improvement guided the analysis. Results Thirty-three participants were interviewed from 11 of the 20 study sites (6 sites from the facilitated KT arm and 5 sites from the passive KT arm). The following factors influencing the implementation of the recommended treatments and KT interventions emerged: facilitation, agreement with the intervention – practical, familiarity with the recommended treatments, and environmental factors, including time and resources. Each of these themes includes the sub-themes of facilitator and/or barrier. Improved team communication and interdisciplinary collaboration emerged as an unintended outcome of the trial across both arms in addition to a facilitator to the implementation of the treatment recommendations. Facilitation was identified as a facilitator to implementation of the KT interventions in the passive KT intervention arm despite the lack of formally instituted facilitators in this arm of the trial. Conclusions This is one of the first studies to examine the factors influencing the implementation of stroke recommendations and associated KT interventions within the context of a trial. Findings highlight the important role of self-selected facilitators to implementation efforts. Future research should seek to better understand the specific characteristics of facilitators that are associated with successful implementation and clinical outcomes, especially within the context of stroke rehabilitation. |
| first_indexed | 2024-12-12T01:59:19Z |
| format | Article |
| id | doaj.art-9c054b835c1946848f52c0b7cfb29675 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-12T01:59:19Z |
| publishDate | 2017-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-9c054b835c1946848f52c0b7cfb296752022-12-22T00:42:15ZengBMCBMC Health Services Research1472-69632017-06-0117111310.1186/s12913-017-2389-7Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trialSarah E. P. Munce0Ian D. Graham1Nancy M. Salbach2Susan B. Jaglal3Carol L. Richards4Janice J. Eng5Johanne Desrosiers6Marilyn MacKay-Lyons7Sharon Wood-Dauphinee8Nicol Korner-Bitensky9Nancy E. Mayo10Robert W. Teasell11Merrick Zwarenstein12Jennifer Mokry13Sandra Black14Mark T. Bayley15Toronto Rehabilitation Institute-University Health NetworkCentre for Practice-Changing Research, The Ottawa Hospital Research InstituteDepartment of Physical Therapy, University of TorontoDepartment of Physical Therapy, University of TorontoDepartment of Rehabilitation, Faculty of Medicine, Université Laval and Centre de Recherche en Réadaptation et Intégration Sociale (CIRRIS)University of British ColumbiaUniversité de Sherbrooke, Faculty of Medicine and Health SciencesOffice 405 Forrest Building, School of Physiotherapy, Dalhousie UniversityMcGill University, School of Physical and Occupational TherapyMcGill University, School of Physical and Occupational TherapyDivision of Clinical Epidemiology, Division of Geriatrics, McGill University Health Center, Royal Victoria Hospital SiteParkwood InstituteSchulich School of Medicine & Dentistry, Western University, Western Centre for Public Health and Family MedicineToronto Rehabilitation Institute-University Health NetworkSunnybrook Health Sciences CentreNeuro Rehabilitation Program, Toronto Rehabilitation Institute-University Health NetworkAbstract Background The Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE-IT) was a cluster randomized controlled trial that evaluated two knowledge translation (KT) interventions for the promotion of the uptake of best practice recommendations for interventions targeting upper and lower extremity function, postural control, and mobility. Twenty rehabilitation centers across Canada were randomly assigned to either the facilitated or passive KT intervention. The objective of the current study was to understand the factors influencing the implementation of the recommended treatments and KT interventions from the perspective of nurses, occupational therapists and physical therapists, and clinical managers following completion of the trial. Methods A qualitative descriptive approach involving focus groups was used. Thematic analysis was used to understand the factors influencing the implementation of the recommended treatments and KT interventions. The Clinical Practice Guidelines Framework for Improvement guided the analysis. Results Thirty-three participants were interviewed from 11 of the 20 study sites (6 sites from the facilitated KT arm and 5 sites from the passive KT arm). The following factors influencing the implementation of the recommended treatments and KT interventions emerged: facilitation, agreement with the intervention – practical, familiarity with the recommended treatments, and environmental factors, including time and resources. Each of these themes includes the sub-themes of facilitator and/or barrier. Improved team communication and interdisciplinary collaboration emerged as an unintended outcome of the trial across both arms in addition to a facilitator to the implementation of the treatment recommendations. Facilitation was identified as a facilitator to implementation of the KT interventions in the passive KT intervention arm despite the lack of formally instituted facilitators in this arm of the trial. Conclusions This is one of the first studies to examine the factors influencing the implementation of stroke recommendations and associated KT interventions within the context of a trial. Findings highlight the important role of self-selected facilitators to implementation efforts. Future research should seek to better understand the specific characteristics of facilitators that are associated with successful implementation and clinical outcomes, especially within the context of stroke rehabilitation.http://link.springer.com/article/10.1186/s12913-017-2389-7FacilitatorsBarriersImplementationEvidence-based recommendationsClinical practice guidelinesRehabilitation |
| spellingShingle | Sarah E. P. Munce Ian D. Graham Nancy M. Salbach Susan B. Jaglal Carol L. Richards Janice J. Eng Johanne Desrosiers Marilyn MacKay-Lyons Sharon Wood-Dauphinee Nicol Korner-Bitensky Nancy E. Mayo Robert W. Teasell Merrick Zwarenstein Jennifer Mokry Sandra Black Mark T. Bayley Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial BMC Health Services Research Facilitators Barriers Implementation Evidence-based recommendations Clinical practice guidelines Rehabilitation |
| title | Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial |
| title_full | Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial |
| title_fullStr | Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial |
| title_full_unstemmed | Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial |
| title_short | Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial |
| title_sort | perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial |
| topic | Facilitators Barriers Implementation Evidence-based recommendations Clinical practice guidelines Rehabilitation |
| url | http://link.springer.com/article/10.1186/s12913-017-2389-7 |
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