title: Clinician adherence to a standardized assessment battery across settings and disciplines in a poststroke rehabilitation population.
abstract: OBJECTIVE
  (1) To examine clinician adherence to a standardized assessment battery across settings (acute hospital, inpatient rehabilitation facilities [IRFs], outpatient facility), professional disciplines (physical therapy [PT], occupational therapy, speech-language pathology), and time of assessment (admission, discharge/monthly), and (2) to evaluate how specific implementation events affected adherence.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Acute hospital, IRF, and outpatient facility with approximately 118 clinicians (physical therapists, occupational therapists, speech-language pathologists).
  
  
  METHODS
  Participants (N=2194) with stroke who were admitted to at least 1 of the above settings. All persons with stroke underwent standardized clinical assessments.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Adherence to Brain Recovery Core assessment battery across settings, professional disciplines, and time. Visual inspections of 17 months of time-series data were conducted to see if the events (eg, staff meetings) increased adherence ≥5% and if so, how long the increase lasted.
  
  
  RESULTS
  Median adherence ranged from .52 to .88 across all settings and professional disciplines. Both the acute hospital and the IRF had higher adherence than the outpatient setting (P≤.001), with PT having the highest adherence across all 3 disciplines (P<.004). Of the 25 events conducted across the 17-month period to improve adherence, 10 (40%) resulted in a ≥5% increase in adherence the following month, with 6 services (60%) maintaining their increased level of adherence for at least 1 additional month.
  
  
  CONCLUSIONS
  Actual adherence to a standardized assessment battery in clinical practice varied across settings, disciplines, and time. Specific events increased adherence 40% of the time with those gains maintained for >1 month 60% of the time.
authors: Program in Physical Therapy, Washington University, Saint Louis, MO 63108, USA. blandm@wusm.wustl.edu
authors: Marghuretta D
authors: MD
authors: Bland
authors: Audra
authors: A
authors: Sturmoski
authors: Michelle
authors: M
authors: Whitson
authors: Hilary
authors: H
authors: Harris
authors: Lisa Tabor
authors: LT
authors: Connor
authors: Robert
authors: R
authors: Fucetola
authors: Jeff
authors: J
authors: Edmiaston
authors: Thy
authors: T
authors: Huskey
authors: Alexandre
authors: A
authors: Carter
authors: Marian
authors: M
authors: Kramper
authors: Maurizio
authors: M
authors: Corbetta
authors: Catherine E
authors: CE
authors: Lang
mesh_terms: D004185:Disability Evaluation; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D013066:Speech-Language Pathology; D018709:Statistics, Nonparametric; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation