Process for developing rehabilitation practice recommendations for individuals with traumatic brain injury.
BACKGROUND
Attempts at measuring quality of rehabilitation care are hampered by a gap in knowledge translation of evidence-based approaches and lack of consensus on best practices. However, adoption of evidence-based best practices is needed to minimize variations and improve quality of care. Therefore, the objective of this project was to describe a process for assessing the quality of evidence of clinical practices in traumatic brain injury (TBI) rehabilitative care.


METHODS
A multidisciplinary team of clinicians developed discipline-specific clinical questions using the Population, Intervention, Control, Outcome process. A systematic review of the literature was conducted for each question using Pubmed, CINAHL, PsychInfo, and Allied Health Evidence databases. Team members assessed the quality, level, and applicability of evidence utilizing a modified Oxford scale, the Agency for Healthcare Research and Quality Methods Guide, and a modified version of the Grading of Recommendations, Assessment, Development, and Evaluation scale.


RESULTS
Draft recommendations for best-practice were formulated and shared with a Delphi panel of clinical representatives and stakeholders to obtain consensus.


CONCLUSIONS
Evidence-based practice guidelines are essential to improve the quality of TBI rehabilitation care. By using a modified quality of evidence assessment tool, we established a process to gain consensus on practice recommendations for individuals with TBI undergoing rehabilitation.
Clinical Research Coordinator, Baylor Institute for Rehabilitation, 909 N. Washington Ave, Dallas, TX, 75246, USA. Librada.Callender@BSWHealth.org.
Librada
L
Callender
Clinical Research Analyst, Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX, USA.
Rachel
R
Brown
Baylor Institute for Rehabilitation, Dallas, TX, USA.
Simon
S
Driver
Center for Medical Psychology, Baylor Regional Medical Center of Plano, Plano, TX, USA.
Marie
M
Dahdah
Office of the Chief Quality Officer, Baylor Scott & White Health, Dallas, TX, USA.
Ashley
A
Collinsworth
Director of Rehabilitation Research, Baylor Institute for Rehabilitation, Dallas, TX, USA.
Shahid
S
Shafi
D000070642:Brain Injuries, Traumatic / Q000534:rehabilitation*; D032921:Consensus; D003697:Delphi Technique; D019317:Evidence-Based Medicine / Q000592:standards*; D006801:Humans; D000066530:Neurological Rehabilitation / Q000379:methods* / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*
Brain injury; Clinical practice guideline; Delphi; Evidence based medicine; Rehabilitation; Traumatic brain injury