Implementation in rehabilitation: a roadmap for practitioners and researchers

Morris, Jacqui H.; Bernhardsson, Susanne; Bird, Marie-Louise; Connell, Louise; Lynch, Elizabeth; Jarvis, Kathryn; Kayes, Nicola M.; Miller, Kim; Mudge, Suzie; Fisher, Rebecca

Abstract

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.

Citation

Morris, J. H., Bernhardsson, S., Bird, M.-L., Connell, L., Lynch, E., Jarvis, K., …Fisher, R. (2019). Implementation in rehabilitation: a roadmap for practitioners and researchers. Disability and Rehabilitation, 40(22), 3265-3274. https://doi.org/10.1080/09638288.2019.1587013

• Journal Article Type: Article
• Acceptance Date: Feb 21, 2019
• Online Publication Date: Apr 12, 2019
• Publication Date: Apr 12, 2019
• Deposit Date: Mar 8, 2019
• Publicly Available Date: Apr 13, 2020
• Journal: Disability and Rehabilitation
• Print ISSN: 0963-8288
• Electronic ISSN: 1464-5165
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 40
• Issue: 22
• Pages: 3265-3274
• DOI: https://doi.org/10.1080/09638288.2019.1587013
• Keywords: Knowledge translation; rehabilitation; implementation science; implementation context
• Public URL: https://nottingham-repository.worktribe.com/output/1620560
• Publisher URL: https://www.tandfonline.com/doi/abs/10.1080/09638288.2019.1587013?journalCode=idre20
• Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 12.04.2019, available online: http://www.tandfonline.com/10.1080/09638288.2019.1587013
• Contract Date: Mar 8, 2019