Implementing SCI-QOL into Clinical Practice to Enhance Patient Engagement

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Routine use of standardized, patient-reported measures of health, function, and quality of life, helps drive evidence-based practice, provides information to evaluate therapy effectiveness, and offers important benefits. These benefits include promoting patient-centered care, facilitating effective clinical team communication, and fostering patients’ confidence during rehabilitation.

Yet, several barriers prevent adoption of standardized, patient-reported measures into routine clinical care, including time limitations, restricted access to measures, and inadequate knowledge about instrument selection and administration. Few instruments are in widespread use to monitor spinal cord injury (SCI) outcomes.  

Accordingly, this study employs implementation science methods to assess the effectiveness of knowledge translation strategies to evaluate, select, and integrate the SCI-QOL measurement system into clinical decision-making during inpatient rehabilitation.

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Patient-reported outcome measures are not routinely used to assess patients’ perspectives because clinicians experience competing time demands, have limited access to these measures, and have limited knowledge about selecting instruments and using assessment results. Other barriers occur when hospitals do not provide access to patient-reported outcome measures, or use electronic medical records that limit patient-reported outcome measures collection and reporting.

This study will identify and address barriers to using patient-reported outcome measures, as well as promote their use in routine clinical care during inpatient SCI rehabilitation. Additionally, this study will use a guided implementation strategy to help clinicians incorporate the use of the SCI-QOL measurement system into clinical care, which will promote patient-centered care and team functioning.

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• Identify barriers and supports to the use of patient-reported SCI-QOL instruments, and identify potential strategies to reduce these barriers during inpatient SCI rehabilitation
• Develop a strategy to facilitate the integration, and sustained use of, SCI-QOL instruments during inpatient SCI rehabilitation
• Implement an intervention to support routine administration of SCI-QOL instruments, evaluate their effects on patient activation and team communication, assess sustainability, and determine generalizability of the intervention to other SCI rehabilitation providers

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Lead by Dr. Allen Heinemann, researchers from the Center for Rehabilitation Outcomes Research (CROR), will facilitate a guided implementation study to incorporate SCI-QOL into routine clinical practice for SCI inpatients. Dr. Ian Graham, an expert on implementation science from the University of Ottawa, and editor of Knowledge Translation in Health Care: Moving from Evidence to Practice, will serve as an external consultant guiding the research team. During this study, Shirley Ryan AbilityLab clinicians will use patient-reported SCI-QOL instruments to assess SCI inpatients using cutting-edge computer adaptive testing technology and iPads, and will be able to review results within Shirley Ryan AbilityLab’s electronic medical record.

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The Craig H. Neilsen Foundation

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May 1, 2016 – April 30, 2018

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Principal Investigator:

Allen Heinemann, Ph.D., Director, Center for Rehabilitation Outcomes Research

Co – Investigators:

Linda Ehrlich-Jones, Ph.D., RN, Assistant Director, Center for Rehabilitation Outcomes Research

Project Coordinator:

Edeth Engel

(312) 238-1405

eengel@sralab.org

External Consultant:

Ian Graham, M.A., Ph.D., FCAHS, Senior Scientist, The Ottawa Hospital Research Institute

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For researcher and students:

Dr. Allen Heinemann

(312) 238-2802

For members of the media:

(312) 238-6044