Category: Cross-Cutting; Health Services Research
Objective: To capture rehabilitation providers' perspectives regarding (1) best practices in the initial post-acute care stay following spinal cord injury (SCI), including barriers and facilitators to implementation, and (2) the development and maintenance of emerging evidence-based practice (EBP).
Design: Two focus groups, 60 minutes each, capitalized on questions informed by Titler’s Translation Research Model. Audio-recordings were transcribed and analyzed using grounded theory.
Setting: Two inpatient rehabilitation facilities with dedicated SCI units were purposively sampled to reflect different organizational structures (i.e., freestanding facility, academic medical center) and practice cultures.
Participants (or Animals, Specimens, Cadavers) : Occupational therapy (n = 8) and physical therapy providers (n = 9) whose primary expertise was SCI rehabilitation.
Interventions: Not applicable.
Main Outcome Measure(s): Not applicable.
Results: Participants defined EBP as a process of finding research that supports interventions performed in the clinic. While there were similarities in sources of new EBP knowledge across settings, the academic medical center providers also capitalized on university research partners and collaborations for emergent strategies. Implementation of EBP was therapist-driven in both settings. Guided by Titler’s implementation framework, barriers to EBP included limited resources, poor communication, a lack of relevant research, low confidence in research skills, and competing priorities and expectations (e.g., between patient and provider). Facilitators to EBP included passionate providers, dedicated research staff on the unit, and funding and incentives to support EBP initiatives. Expertise was developed and maintained through mentorship, engagement with individuals with SCI, and professional development activities (e.g., conference attendance).
Conclusions: SCI rehabilitation providers perceive more barriers than facilitators to implementing EBP. To optimize SCI outcomes, evidence is needed that (1) identifies effective strategies to translate research to the clinic and (2) improves providers’ research competence.
Alexandra Harper– Graduate Student Researcher, University of Pittsburgh, Pittsburgh, Pennsylvania
Lauren Terhorst– Associate Professor and Biostatistician, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
Cara Lekovitch– Geriatric Research Program Manager, University of Pittsburgh, Irwin, Pennsylvania
Natalie Leland– Associate Professor, University of Pittsburgh, Pittsburgh, Pennsylvania