Promoting Knowledge Translation in Neurologic Physical Therapy through Changes to Inpatient Rehabilitation Documentation.

Special Interest Report
Population: Both

Amelia B Siles, DPT, NCS, Clinical Assistant Professor, Ohio State University

Lindsay Frysinger, DPT, Physical Therapist, Ohio State University

David Haley, DPT, NCS, Physical Therapist, Ohio State University

Mary Hubert, PT, DPT, Physical Therapist, Ohio State University

Keywords: Plasticity, Knowledge Translation, Documentation, Outcome Measures

PURPOSE:   To describe the process and product of appraising the evaluation documentation of one inpatient rehabilitation unit in a large academic medical center.  The changes were designed to promote knowledge translation (KT) of current evidence in neurologic physical therapy (PT), streamline content between the academic and clinical sites, and to be able to aggregate and assess patient care outcomes.

DESCRIPTION: Evidence to support neurologic clinical practice is growing exponentially.   Translating this evidence into practice can be complex, and there is a substantial delay between knowledge creation and application in the clinic. 1 Some recent examples of successful knowledge translation include trends toward increased recovery-based interventions in treating clients with spinal cord injury and more widespread use of standardized outcomes measures.2-3  In order to maximize these types of trends, it is crucial to maintain the clinical infrastructure to support the translation of evidence to practice.  One aspect of this clinical infrastructure is documentation content.

This presentation describes the process of updating the electronic medical record (EMR) at Ohio State University’s Dodd Rehabilitation Hospital, and how this can support knowledge translation, as viewed through a KT model.4   A Steering Committee led the process, informed through peer review and a PT student practicum project.  Changes included integration of the ICF model, more efficient access to the most appropriate outcomes measures and interpretation tools, and use of terminology consistent with the PT Guide and the PT Patient/Client Management Model.  During the process, a priority was to streamline the format of documentation across levels of care.  The changes are expected to enhance evidence-based practice decisions and improve the PT student experience within this teaching hospital.  A long-term goal is to be able to aggregate data from the EMR in order to assess patient outcomes and optimize quality of care.

SUMMARY OF USE:  Other rehabilitation department stakeholders may use this presentation to inform their self-assessment of EMR documentation and how this can better support evidence-based practice.  This presentation can also serve as an example of collaboration between the academic PT program and clinical partners within a large academic medical center setting.  A practicum student project can be a “win-win” mechanism to this type of process.

IMPORTANCE TO MEMBERS:  At the heart of all researchers, committed clinicians, academic faculty and PT students is the desire to know and practice in the most evidence-based manner.  This presentation provides a tangible example of the study of knowledge translation, assessing barriers and implementing changes to documentation with the intent to improve evidence-based practice and ultimately patient care outcomes.

  1. Balas EA, Boren SA. Yearbook of Medical Informatics: Managing Clinical Knowledge for Health Care Improvement. Stuttgart, Germany: Schattauer Verlagsgesellschaft mbH; 2000
  2. Harkema, Susan.”Evidence-based therapy for recovery of function after spinal cord injury”. Handbook of clinical neurology (0072-9752). 2012; 109, 259.
  3. Damiano DL, DeJong SL. A Systematic Review of the Effectiveness of Treadmill Training and Body Weight Support in Pediatric Rehabilitation.Journal of neurologic physical therapy : JNPT. 2009; 33(1):27-44.
  4. Straus SE, Tetroe J, Graham ID, eds. Knowledge Translation in Health Care: Moving From Evidence to Practice. 2nd ed. Chichester, United Kingdom: John Wiley & Sons Ltd; 2013.

Siles, Amelia B, DPT, NCS; Frysinger, Lindsay , DPT; Haley, David , DPT, NCS; Hubert, Mary , PT, DPT. Promoting Knowledge Translation in Neurologic Physical Therapy through Changes to Inpatient Rehabilitation Documentation.. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online.