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A multi-faceted knowledge translation approach to support persons with stroke and cognitive impairment: evaluation protocol.

McEwen SE, Donald M, Dawson D, Egan MY, Hunt A, Quant S, Runions S, Linkewich E - Implement Sci (2015)

Bottom Line: Study 1 will be a quasi-experimental, interrupted time series design measuring monthly summaries of stroke unit level data.Study 2, which relates to changes in health care professional practice and self-efficacy, will be a single group pre-post evaluation design incorporating chart audits and a self-report survey.This project will advance knowledge about the degree to which the implementation of a supported KT initiative can sustainably change health system, knowledge, and patient outcomes.

View Article: PubMed Central - PubMed

Affiliation: Sunnybrook Research Institute, Toronto, Canada. sara.mcewen@utoronto.ca.

ABSTRACT

Background: Patients with cognitive impairments following a stroke are often denied access to inpatient rehabilitation. The few patients with cognitive impairment admitted to rehabilitation generally receive services based on outdated impairment-reduction models, rather than recommended function-based approaches. Both reduced access to rehabilitation and the knowledge-to-practice gap stem from a reported lack of skills and knowledge regarding cognitive rehabilitation on the part of inpatient rehabilitation team members. To address these issues, a multi-faceted knowledge translation (KT) initiative will be implemented and evaluated. It will be targeted specifically at the inter-professional application of the cognitive orientation to daily occupational performance (CO-OP). CO-OP training combined with KT support is called CO-OP KT. The long-term objective of CO-OP KT is to optimize functional outcomes for individuals with stroke and cognitive impairments. Three research questions are posed: 1. Is the implementation of CO-OP KT associated with a change in the proportion of patients with cognitive impairment following a stroke accepted to inpatient rehabilitation? 2. Is the implementation of CO-OP KT associated with a change in rehabilitation clinicians' practice, knowledge, and self-efficacy related to implementing the CO-OP approach, immediately following and 1 year later? 3. Is CO-OP KT associated with changes in activity, participation, and self-efficacy to perform daily activities in patients with cognitive impairment following stroke at discharge from inpatient rehabilitation and at 1-, 3-, and 6-month follow-ups?

Methods/design: Three interrelated studies will be conducted. Study 1 will be a quasi-experimental, interrupted time series design measuring monthly summaries of stroke unit level data. Study 2, which relates to changes in health care professional practice and self-efficacy, will be a single group pre-post evaluation design incorporating chart audits and a self-report survey. Study 3 will assess patient functional outcomes using a non-randomized design with historical controls. Assessments will occur during admission and discharge from rehabilitation and at 1, 3, and 6 months following discharge from rehabilitation.

Discussion: This project will advance knowledge about the degree to which the implementation of a supported KT initiative can sustainably change health system, knowledge, and patient outcomes.

No MeSH data available.


Related in: MedlinePlus

Knowledge to action framework with CO-OP KT project content. Adapted from Graham et al. [20], the KTA framework consists of an inner knowledge creation cycle, depicted here as an inverse triangle; and a concurrent action cycle, depicted here as the external circles. CO-OP cognitive orientation to occupational performance, IF implementation facilitator, TSNs Toronto Stroke Networks, VCoP virtual community of practice, ITS interrupted time series, KT knowledge translation
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Fig1: Knowledge to action framework with CO-OP KT project content. Adapted from Graham et al. [20], the KTA framework consists of an inner knowledge creation cycle, depicted here as an inverse triangle; and a concurrent action cycle, depicted here as the external circles. CO-OP cognitive orientation to occupational performance, IF implementation facilitator, TSNs Toronto Stroke Networks, VCoP virtual community of practice, ITS interrupted time series, KT knowledge translation

Mentions: The knowledge to action framework developed by Graham et al. provides the foundation for this project [20]. The knowledge to action framework consists of a central knowledge creation cycle and a concurrent action cycle. Figure 1 depicts the knowledge to action framework with content specific to the CO-OP KT project. In preparatory work, issues were identified and knowledge was synthesized to develop strategies to mitigate those issues. The results led to development of the current project which begins with the phase of adapting the knowledge to the local context and identifying barriers to knowledge uptake, and will continue with selecting, tailoring, and implementing KT intervention, monitoring and sustaining knowledge use, and evaluating outcomes.Fig. 1


A multi-faceted knowledge translation approach to support persons with stroke and cognitive impairment: evaluation protocol.

McEwen SE, Donald M, Dawson D, Egan MY, Hunt A, Quant S, Runions S, Linkewich E - Implement Sci (2015)

Knowledge to action framework with CO-OP KT project content. Adapted from Graham et al. [20], the KTA framework consists of an inner knowledge creation cycle, depicted here as an inverse triangle; and a concurrent action cycle, depicted here as the external circles. CO-OP cognitive orientation to occupational performance, IF implementation facilitator, TSNs Toronto Stroke Networks, VCoP virtual community of practice, ITS interrupted time series, KT knowledge translation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4635536&req=5

Fig1: Knowledge to action framework with CO-OP KT project content. Adapted from Graham et al. [20], the KTA framework consists of an inner knowledge creation cycle, depicted here as an inverse triangle; and a concurrent action cycle, depicted here as the external circles. CO-OP cognitive orientation to occupational performance, IF implementation facilitator, TSNs Toronto Stroke Networks, VCoP virtual community of practice, ITS interrupted time series, KT knowledge translation
Mentions: The knowledge to action framework developed by Graham et al. provides the foundation for this project [20]. The knowledge to action framework consists of a central knowledge creation cycle and a concurrent action cycle. Figure 1 depicts the knowledge to action framework with content specific to the CO-OP KT project. In preparatory work, issues were identified and knowledge was synthesized to develop strategies to mitigate those issues. The results led to development of the current project which begins with the phase of adapting the knowledge to the local context and identifying barriers to knowledge uptake, and will continue with selecting, tailoring, and implementing KT intervention, monitoring and sustaining knowledge use, and evaluating outcomes.Fig. 1

Bottom Line: Study 1 will be a quasi-experimental, interrupted time series design measuring monthly summaries of stroke unit level data.Study 2, which relates to changes in health care professional practice and self-efficacy, will be a single group pre-post evaluation design incorporating chart audits and a self-report survey.This project will advance knowledge about the degree to which the implementation of a supported KT initiative can sustainably change health system, knowledge, and patient outcomes.

View Article: PubMed Central - PubMed

Affiliation: Sunnybrook Research Institute, Toronto, Canada. sara.mcewen@utoronto.ca.

ABSTRACT

Background: Patients with cognitive impairments following a stroke are often denied access to inpatient rehabilitation. The few patients with cognitive impairment admitted to rehabilitation generally receive services based on outdated impairment-reduction models, rather than recommended function-based approaches. Both reduced access to rehabilitation and the knowledge-to-practice gap stem from a reported lack of skills and knowledge regarding cognitive rehabilitation on the part of inpatient rehabilitation team members. To address these issues, a multi-faceted knowledge translation (KT) initiative will be implemented and evaluated. It will be targeted specifically at the inter-professional application of the cognitive orientation to daily occupational performance (CO-OP). CO-OP training combined with KT support is called CO-OP KT. The long-term objective of CO-OP KT is to optimize functional outcomes for individuals with stroke and cognitive impairments. Three research questions are posed: 1. Is the implementation of CO-OP KT associated with a change in the proportion of patients with cognitive impairment following a stroke accepted to inpatient rehabilitation? 2. Is the implementation of CO-OP KT associated with a change in rehabilitation clinicians' practice, knowledge, and self-efficacy related to implementing the CO-OP approach, immediately following and 1 year later? 3. Is CO-OP KT associated with changes in activity, participation, and self-efficacy to perform daily activities in patients with cognitive impairment following stroke at discharge from inpatient rehabilitation and at 1-, 3-, and 6-month follow-ups?

Methods/design: Three interrelated studies will be conducted. Study 1 will be a quasi-experimental, interrupted time series design measuring monthly summaries of stroke unit level data. Study 2, which relates to changes in health care professional practice and self-efficacy, will be a single group pre-post evaluation design incorporating chart audits and a self-report survey. Study 3 will assess patient functional outcomes using a non-randomized design with historical controls. Assessments will occur during admission and discharge from rehabilitation and at 1, 3, and 6 months following discharge from rehabilitation.

Discussion: This project will advance knowledge about the degree to which the implementation of a supported KT initiative can sustainably change health system, knowledge, and patient outcomes.

No MeSH data available.


Related in: MedlinePlus