Effect and process evaluation of implementing standardized tests to monitor patients in spinal cord injury rehabilitation.
OBJECTIVE
To evaluate the implementation of standardized physical and functional tests to monitor patients with a spinal cord injury (SCI) in eight rehabilitation centers and to analyze the enablers and the barriers of the implementation process.


METHODS
The method involved prospective effect and process evaluation. Team members responded to mailed questionnaires at the start (n = 115) and end (n = 82) of the 1-year implementation period. Furthermore, a questionnaire was administered to managers (n = 8), coordinators (n = 8), and 32 persons with SCI in four centers. Outcome of the effect evaluation was the phase of implementation of standardized testing in each center. The process evaluation analyzed enablers and barriers of the implementation process.


RESULTS
After a year of implementation, half of the centers shifted to higher implementation phases. None of the centers was classified in the highest phase. Enablers were the positive attitude of the team members regarding standardized testing and an encouraging local coordinator. Most important barrier was lack of time to implement the standardized testing.


CONCLUSIONS
There is a large support for implementing standardized tests to monitor patients with SCI. During the 1-year, a positive shift was visible in the extent of implementation. Successful implementation of patient monitoring requires substantial amounts of time and effort of the rehabilitation centers involved.
de Groot
Sonja
S
Duyvensz-Nagel Research Laboratory, Rehabilitation Center Amsterdam, Amsterdam, The Netherlands. s.d.groot@rcamsterdam.nl
Bevers
Geertje
G
Post
Marcel W M
MW
Woldring
Ferry A B
FA
Mulder
Dineke G A
DG
van der Woude
Lucas H V
LH
D004185:Disability Evaluation; D019983:Guideline Adherence; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000592:standards; D017410:Practice Guidelines as Topic; D020127:Recovery of Function; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000534:rehabilitation*