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Christensen J.,Kawartha Regional Orthopedic Specialists | Andrysek J.,Holland Bloorview Kids Rehabilitation Hospital
Prosthetics and Orthotics International | Year: 2012

Background: An important way of improving healthcare services is through the implementation of evidence-based practice; but this requires an understanding of the extent to which it is occurring and the factors that are driving its implementation.Objective: To examine the associations among the demographics of clinicians, the factors involved in the implementation of evidence-based practice, and the access of clinicians to various sources of information.Study Design: Cross-sectional survey.Methods: An online survey that was distributed to 300 Canadian prosthetic and orthotic clinicians. Associations of selected survey items were determined.Results: Four primary associations were found and a further 18 were considered to be indicative of potential trends. Two of the primary associations were related to authorship and the utilization of scientific literature. Specifically, those clinicians who had previously authored or co-authored a peer-reviewed journal article were more likely to utilize scientific literature to guide their clinical practice.Conclusions: This study has highlighted important demographics which can be targeted for greater implementation of evidence-based practice. Above all, facilitating engagement of clinicians in research and its dissemination may promote a higher consumption of research evidence leading to improved evidence-based practice.Clinical relevanceThis study provides information about the underlying facilitators and inhibitors of evidence-based practice in prosthetics and orthotics. The findings aim to inform those involved in improving existing clinical practices, including educators, professional organizations and governing bodies. © International Society for Prosthetics and Orthotics International 2011.

Growing demand from clients waiting to access vital services in a healthcare sector under economic constraint, coupled with the pressure for ongoing improvement within a multi-faceted organization, can have a significant impact on the front-line staff, who are essential to the successful implementation of any quality improvement initiative. The Lean methodology is a management system for continuous improvement based on the Toyota Production System; it focuses on two main themes: respect for people and the elimination of waste or non-value-added activities. Within the Lean process, value-added is used to describe any activity that contributes directly to satisfying the needs of the client, and non-value-added refers to any activity that takes time, space or resources but does not contribute directly to satisfying client needs. Through the revision of existing models of service delivery, the authors' organization has made an impact on increasing access to care and has supported successful engagement of staff in the process, while ensuring that the focus remains on the central needs of clients and families accessing services. While the performance metrics continue to exhibit respectable results for this strategic priority, further gains are expected over the next 18-24 months.

Brewer K.,Holland Bloorview Kids Rehabilitation Hospital | Brewer K.,University of Toronto | Pollock N.,McMaster University | Wright F.V.,Bloorview Research Institute
Physical and Occupational Therapy in Pediatrics | Year: 2014

Collaborative goal setting between clinicians and clients/families is considered a fundamental component of the pediatric rehabilitation process. However, truly client-centered goal setting is not without its challenges. The purpose of this paper is to highlight theoretical concepts relevant to rehabilitation goal setting, review clinical studies directly evaluating relationships between goal setting and pediatric rehabilitation outcomes, and provide recommendations to facilitate collaborative goal processes. Four theoretical frameworks were identified that may lie behind and help explain the effectiveness of collaborative goal setting. The four relevant outcome studies found in the review revealed that individualized goal setting is an important component of the intervention, engages families more actively in therapy, and is associated to some extent with positive outcomes. The evidence suggests that the impact of fully collaborative goal setting is sufficiently positive to support investment of organizational and individual time, energy, and resources to make it an integral part of the rehabilitation process. © 2014 Informa Healthcare USA, Inc.

Moreno J.A.,University of Montreal | Arango Lasprilla J.C.,University of Deusto | Gan C.,Holland Bloorview Kids Rehabilitation Hospital | Mckerral M.,University of Montreal
NeuroRehabilitation | Year: 2013

Brain injury can directly and indirectly affect important aspects related to sexuality and sexual function. In this critical review of the literature, traumatic brain injury (TBI) and sexuality are examined. A general review of the concept of sexuality and the neurological correlates of sexual function are proposed as a framework to understand the cognitive, behavioral and physical effects of TBI on sexuality and sexual function. Studies are then classified according to the participants enrolled and findings are presented from the professional's, the survivor's, the patient/partner's, and the non-injured spouse's perspectives. Results are discussed taking into account methodological limitations and knowledge gaps. Next, implications for sexual rehabilitation for individuals with TBI are discussed. Finally, suggestions for future research and their pertinence for improving rehabilitation outcomes are considered. © 2013 - IOS Press and the authors. All rights reserved.

Edelstein H.,Holland Bloorview Kids Rehabilitation Hospital
Evidence and Policy | Year: 2016

This study examines elements of collaborative research partnerships (CRPs) between university researchers and organisations who engage in knowledge mobilisation activities in education. The study uses key informant interviews and document analysis from one type of partnership, and a survey of university-community partnerships across Canada to explore this phenomenon. Findings demonstrate that working across university researchers and community organisations builds capacity for research use to inform decision making; CRPs are more informal than formal entities; how partners communicate is integral to their success; variance in partnership involvement does not impact the success of the partnership in goal meeting. © Policy Press 2016.

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