TY - JOUR
T1 - Implementation in rehabilitation
T2 - A roadmap for practitioners and researchers
AU - Morris, Jacqui
AU - Bernhardsson, Susanne
AU - Bird, Marie-Louise
AU - Connell, Louise
AU - Lynch, Elizabeth
AU - Jarvis, Kathryn
AU - Kayes, Nicola M.
AU - Miller, Kim
AU - Mudge, Suzie
AU - Fisher, Rebecca
PY - 2020/10/22
Y1 - 2020/10/22
N2 - Purpose: Despite growth in rehabilitation research, implementing research findings into rehabilitation practice has been slow. This creates inequities for patients and is an ethical issue. However, methods to investigate and facilitate evidence implementation are being developed. This paper aims to make these methods relevant and accessible for rehabilitation researchers and practitioners. Methods: Rehabilitation practice is varied and complex and occurs within multilevel healthcare systems. Using a “road map” analogy, we describe how implementation concepts and theories can inform implementation strategies in rehabilitation. The roadmap involves a staged journey that considers: the nature of evidence; context for implementation; navigation tools for implementation; strategies to facilitate implementation; evaluation of implementation outcomes; and sustainability of implementation. We have developed a model to illustrate the journey, and four case studies exemplify implementation stages in rehabilitation settings. Results and Conclusions: Effective implementation strategies for the complex world of rehabilitation are urgently required. The journey we describe unpacks that complexity to provide a template for effective implementation, to facilitate translation of the growing evidence base in rehabilitation into improved patient outcomes. It emphasizes the importance of understanding context and application of relevant theory, and highlights areas which should be targeted in new implementation research in rehabilitation.Implications for rehabilitation Effective implementation of research evidence into rehabilitation practice has many interconnected steps and a roadmap analogy is helpful in defining them. Understanding context for implementation is critically important and using theory can facilitate development of understanding. Research methods for implementation in rehabilitation should be carefully selected and outcomes should evaluate implementation success as well as clinical change. Sustainability requires regular revisiting of the interconnected steps.
AB - Purpose: Despite growth in rehabilitation research, implementing research findings into rehabilitation practice has been slow. This creates inequities for patients and is an ethical issue. However, methods to investigate and facilitate evidence implementation are being developed. This paper aims to make these methods relevant and accessible for rehabilitation researchers and practitioners. Methods: Rehabilitation practice is varied and complex and occurs within multilevel healthcare systems. Using a “road map” analogy, we describe how implementation concepts and theories can inform implementation strategies in rehabilitation. The roadmap involves a staged journey that considers: the nature of evidence; context for implementation; navigation tools for implementation; strategies to facilitate implementation; evaluation of implementation outcomes; and sustainability of implementation. We have developed a model to illustrate the journey, and four case studies exemplify implementation stages in rehabilitation settings. Results and Conclusions: Effective implementation strategies for the complex world of rehabilitation are urgently required. The journey we describe unpacks that complexity to provide a template for effective implementation, to facilitate translation of the growing evidence base in rehabilitation into improved patient outcomes. It emphasizes the importance of understanding context and application of relevant theory, and highlights areas which should be targeted in new implementation research in rehabilitation.Implications for rehabilitation Effective implementation of research evidence into rehabilitation practice has many interconnected steps and a roadmap analogy is helpful in defining them. Understanding context for implementation is critically important and using theory can facilitate development of understanding. Research methods for implementation in rehabilitation should be carefully selected and outcomes should evaluate implementation success as well as clinical change. Sustainability requires regular revisiting of the interconnected steps.
KW - Knowledge translation
KW - implementation context
KW - implementation science
KW - rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85064484696&partnerID=8YFLogxK
U2 - 10.1080/09638288.2019.1587013
DO - 10.1080/09638288.2019.1587013
M3 - Article
C2 - 30978129
SN - 0963-8288
VL - 42
JO - Disability and Rehabilitation
JF - Disability and Rehabilitation
IS - 22
ER -