Translating clinical practice guidelines into rehabilitation using audit and feedback

L Jolliffe, Natasha Lannin, T Hoffmann, J Morarty, E O'Shannessy, P Hunter, Ian Cameron, Maria Crotty

    Research output: Contribution to conferencePaperpeer-review

    Abstract

    Background and Rationale: There is evidence of a gap
    between the rehabilitation that stroke patients receive and what
    that is recommended in clinical practice guidelines (CPGs). Audit/
    feedback on adherence to CPGs are usually provided in limited
    doses with great expectation for change in behaviour. This study
    evaluated the effects of a sustained, fortnightly intervention of audit/
    feedback on adherence to stroke rehabilitation CPGs.
    Methods: Using a periodic service review methodology, rehabilitation
    care was audited fortnightly for a year against ten published
    CPGs, including the National Stroke Foundation Rehabilitation
    guidelines. Together these CPGs produced n = 132 observable
    criteria. Each fortnight, two patients were randomly selected and
    audited against the observable criteria. Adherence was graphed
    and summarised into rehabilitation intervention areas, and feedback
    sessions were then facilitated with clinicians. These feedback
    sessions summarised the observed clinical adherence and, using a
    positive behavioural support model, encouraged clinicians to adjust
    their performance.
    Results: Twenty three audit/feedback cycles were completed
    during the study. Adherence to the CPGs was observed during the
    study period, resulting in an improvement from 34% to 96% adherence
    to the possible 132 guidelines (baseline to end of year). Thus,
    using an audit/feedback intervention achieved a 54% increase in
    adherence to CGPs (p = 0.0001).
    Conclusion: Findings have demonstrated that it is possible
    to improve clinical adherence to rehabilitation CPGs using an intensive
    audit/feedback method. To achieve sustainable change in
    practice we recommend that audit/feedback is incorporated into
    usual rehabilitation, and thus, becomes the responsibility of clinicians
    rather than researchers.
    Original languageEnglish
    DOIs
    Publication statusPublished - 2016
    EventAnnual Conference of the Asia Pacific Stroke Conference (APSO) Combined with Stroke Society of Australasia -
    Duration: 14 Jul 2016 → …

    Conference

    ConferenceAnnual Conference of the Asia Pacific Stroke Conference (APSO) Combined with Stroke Society of Australasia
    Period14/07/16 → …

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