title: Knowledge translation and implementation in spinal cord injury: a systematic review.
abstract: OBJECTIVE
  To conduct a systematic review examining the effectiveness of knowledge translation (KT) interventions in changing clinical practice and patient outcomes.
  
  
  METHODS
  MEDLINE/PubMed, CINAHL, EMBASE and PsycINFO were searched for studies published from January 1980 to July 2012 that reported and evaluated an implemented KT intervention in spinal cord injury (SCI) care. We reviewed and summarized results from studies that documented the implemented KT intervention, its impact on changing clinician behavior and patient outcomes as well as the facilitators and barriers encountered during the implementation.
  
  
  RESULTS
  A total of 13 articles featuring 10 studies were selected and abstracted from 4650 identified articles. KT interventions included developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice. The methods (or drivers) to facilitate the implementation included organizing training sessions for clinical staff, introducing computerized reminders and involving organizational leaders. The methodological quality of studies was mostly poor. Only 3 out of 10 studies evaluated the success of the implementation using statistical analyses, and all 3 reported significant behavior change. Out of the 10 studies, 6 evaluated the effect of the implementation on patient outcomes using statistical analyses, with 4 reporting significant improvements. The commonly cited facilitators and barriers were communication and resources, respectively.
  
  
  CONCLUSIONS
  The field of KT in SCI is in its infancy with only a few relevant publications. However, there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. Future studies should ensure rigorous study methods are used to evaluate KT interventions.
authors.affiliation: 1] Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada [2] Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: V K
authors.initials: VK
authors.lastname: Noonan
authors.affiliation: 1] Program of Aging, Rehabilitation and Geriatric Care, Lawson Health Research Institute, London, Ontario, Canada [2] Department of Physical Medicine and Rehabilitation, Western University, London, Ontario, Canada.
authors.forename: D L
authors.initials: DL
authors.lastname: Wolfe
authors.affiliation: Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: N P
authors.initials: NP
authors.lastname: Thorogood
authors.affiliation: 1] Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada [2] Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: S E
authors.initials: SE
authors.lastname: Park
authors.affiliation: Program of Aging, Rehabilitation and Geriatric Care, Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: J T
authors.initials: JT
authors.lastname: Hsieh
authors.affiliation: 1] Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada [2] International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada.
authors.forename: J J
authors.initials: JJ
authors.lastname: Eng
mesh_terms: D000818:Animals; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D019359:Knowledge; D013119:Spinal Cord Injuries / Q000628:therapy*; D057170:Translational Research, Biomedical