Can Clinical Practice Changes be Sustained Two Years after Implementation Using a Knowledge to Action Framework?
Rose, Carter J
Rose, Carter J
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Abstract
Purpose The aim is to describe the use of recommended stroke outcome measures (OM) by physical therapist (PTs) two years after the implementation of a network wide PT Stroke OM Toolbox. Background/ Description Clinicians use OMs to quantify the patient’s initial status and response to treatment. Using the Knowledge to Action (KTA) Framework, clinicians across the University of Vermont Health Network implemented a preferred stroke OM toolbox in 2016 across four hospitals in VT and NY. Methods Thirty-two patients with acute stroke were randomly selected and audited from the acute care (AC), inpatient rehab (IPR) and the outpatient (OP) clinic. Three key metrics were analyzed to assess sustained clinical performance from baseline to 2 years. The metrics included: percentage of cases where PTs administered at least one PT stroke OM one time, percentage of cases where the PT administered at least one PT stroke OM two times, and percentage of OMs administered that have the clinical relevance documented. Results from cycle five were compared to cycle four and compared against site targets. Sustained clinical performance was defined as cycle five results within 5 percent of cycle four results and site targets. Results Cycle five measurement of clinician performance compared to cycle four demonstrated that clinicians had sustained their performance across all three metrics in AC, IPR, and OP practices. All sites improved their performance beyond five percent when compared to cycle four. Conclusion: Clinicians audited at the end of the sustainability phase of the KTA cycle demonstrated that they had sustained new clinical practice changes. The sustainability model used in the KTA framework was successful in spite of having fewer meetings, audits and less performance feedback.
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1:00 PM
3:00pm-5:00pm
Undergraduate
3:00pm-5:00pm
Undergraduate
Date
2019-01-01