Article

OBJECTIVES: (1) To examine clinician adherence to a standardized assessment
battery across settings (acute hospital, inpatient rehabilitation facilities
[IRFs], outpatient facility), professional disciplines (physical therapy [PT],
occupational therapy, speech-language pathology), and time of assessment
(admission, discharge/monthly), and (2) to evaluate how specific implementation
events affected adherence. DESIGN: Retrospective cohort study. SETTING: Acute
hospital, IRF, and outpatient facility with approximately 118 clinicians
(physical therapists, occupational therapists, speech-language pathologists).
PARTICIPANTS: Participants (N=2194) with stroke who were admitted to at least 1
of the above settings. All persons with stroke underwent standardized clinical
assessments. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Adherence to
Brain Recovery Core assessment battery across settings, professional disciplines,
and time. Visual inspections of 17 months of time-series data were conducted to
see if the events (eg, staff meetings) increased adherence >/=5% and if so, how
long the increase lasted. RESULTS: Median adherence ranged from .52 to .88 across
all settings and professional disciplines. Both the acute hospital and the IRF
had higher adherence than the outpatient setting (P</=.001), with PT having the
highest adherence across all 3 disciplines (P<.004). Of the 25 events conducted
across the 17-month period to improve adherence, 10 (40%) resulted in a >/=5%
increase in adherence the following month, with 6 services (60%) maintaining
their increased level of adherence for at least 1 additional month. CONCLUSIONS:
Actual adherence to a standardized assessment battery in clinical practice varied
across settings, disciplines, and time. Specific events increased adherence 40%
of the time with those gains maintained for >1 month 60% of the time.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS