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. 2017 Oct 15;34(20):2934-2940.
doi: 10.1089/neu.2016.4938. Epub 2017 Aug 2.

Using Evidence To Inform Practice and Policy To Enhance the Quality of Care for Persons With Traumatic Spinal Cord Injury

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Using Evidence To Inform Practice and Policy To Enhance the Quality of Care for Persons With Traumatic Spinal Cord Injury

Michael G Fehlings et al. J Neurotrauma. .
Free PMC article

Abstract

In today's economic climate, there is a need to demonstrate a return on investment for healthcare spending and for clinical practice and policy to be informed by evidence. Navigating this process is difficult for decision-makers, clinicians, and researchers alike. This article will describe how a knowledge translation framework and an evidence-based policy-making process were integrated to clarify the problem, frame options, and plan implementation, to impact clinical practice and policy in the area of traumatic spinal cord injury (tSCI). The Access to Care and Timing (ACT) project is focused on optimizing the access and timing of specialized healthcare delivery for persons sustaining a tSCI in Canada. A simulation model was developed that uses current patient data to address complex problems faced by the healthcare system. At a workshop, participants stressed the importance of linking interventions to short- and long-term outcomes to drive change. Presently, there are no national, system level indicators to monitor performance after tSCI. Although the ideal system of care after tSCI is unknown, indicator collection will establish a baseline to measure improvement. The workshop participants prioritized two indicators important from the clinician and patient perspective-timely admission to rehabilitation and meaningful community participation. The ACT simulation model for tSCI care will be used to promote the uptake of identified indicators and provide a predictive link between interventions on potential outcomes. The standardized collection of outcome-oriented indicators will help to evaluate the access and timing of care and to define the ideal system of care after SCI.

Keywords: indicators; policy making; practice change; specialized care; spinal cord injury.

Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Integration of Knowledge to Action cycle and evidence-based policy-making process. (Adapted from Lost in knowledge translation: Time for a map? Graham ID, et al Journal of Continuing Education in the Health Professions, 26. Copyright © 2006. The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education. Used with permission.)
<b>FIG. 2.</b>
FIG. 2.
Describing the Access to Care and Timing (ACT) project using an evidence-based policy-making framework. SCI, spinal cord injury.
<b>FIG. 3.</b>
FIG. 3.
State of spinal cord injury care in Canada. Collaborative effort is needed to move from the segregated current state (A) to the proposed integrated future state (B). Reprinted from ACT Workshop Proceedings, 2014; published by Rick Hansen Institute, Vancouver, BC, Canada. SCI, spinal cord injury; ACT, Access to Care and Timing; CIHI, Canadian Institute for Health Information; DAD, Discharge Abstract Database; NRS, National Rehabilitation Reporting System; CCRS, Continuing Care Reporting System.

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References

    1. World Health Organization. (2015). Chronic diseases and health promotion. Available at: www.who.int/chp/en/ Accessed July1, 2015
    1. Krueger H., Noonan V.K., Trenaman L.M., Joshi P., and Rivers C.S. (2013). The economic burden of traumatic spinal cord injury in Canada. Chronic Dis. Inj. Can. 33, 113–122 - PubMed
    1. Dryden D.M., Saunders L.D., Rowe B.H., May L., Yiannakoulias N., Svenson L.W., Schopflocher D.P., and Voaklander D.C. (2004). Utilization of health services following spinal cord injury: a 6-year follow-up study. Spinal Cord 42, 513–525 - PubMed
    1. Munce S.E., Guilcher S.J., Couris C.M., Fung K., Craven B.C., Verrier M., and Jaglal S.B. (2009). Physician utilization among adults with traumatic spinal cord injury in Ontario: a population-based study. Spinal Cord 47, 470–476 - PubMed
    1. Guilcher S.J., Munce S.E., Couris C.M., Fung K., Craven B.C., Verrier M., and Jaglal S.B. (2010). Health care utilization in non-traumatic and traumatic spinal cord injury: a population-based study. Spinal Cord 48, 45–50 - PubMed

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