A Survey of Perceived Implementation Gaps for a Clinical Practice Guideline for the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury

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Abstract

Objective:

Appraising current practice is an important prerequisite for implementation of clinical practice guidelines (CPGs). The study objective was to determine the perceived level of implementation, priority, and feasibility of a subset of key CPG recommendations for the rehabilitation of individuals with moderate to severe traumatic brain injury (MSTBI).

Methods:

Fifty-one teams at acute care and rehabilitation facilities were invited to complete an electronic survey addressing the perceived level of implementation, priority, and feasibility of 109 fundamental and priority recommendations from the CPG-MSTBI.

Results:

Forty-four clinical teams responded across 2 Canadian provinces. Most of the recommendations were deemed as “fully” or “mostly” implemented, while relative gaps in implementation were perceived in recommendations regarding coordination with mental health and addiction providers (>75% of respondents indicated low levels of implementation), “Caregivers and Families” (26%), and “Psychosocial and Adaptation Issues” (25%). Priority levels and perceived feasibility were generally high (>60% and >86%, respectively) for recommendations with low levels of implementation. Priority recommendations for implementation were identified for both acute care and rehabilitation settings in Québec and Ontario.

Conclusions:

Assessment of clinician perception provides a helpful perspective for implementation. Exploring perceived implementation gaps based on users' needs and expectation should be a part of an implementation process.

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