Background: Despite research evidence supporting best practices in acute stroke care, gaps in translating this research into everyday occupational therapy practice exist. At Alfred Health, a working group was formed to support the translation of the Australian and New Zealand Clinical Guidelines for Stroke Management on an acute stroke unit.
Aims: To develop and pilot a tailored multifaceted implementation program to improve adherence to acute clinical practice guidelines by occupational therapists.
Methods: The working group applied the Knowledge-To-Action Framework (KTAF) to first review the guidelines and select those applicable to occupational therapists. Actions were prioritised based on past acute audit results (2021) before reviewing existing research literature. A multifaceted quality improvement intervention was developed including a clinical pathway, evidence-based work instructions, and routine data collection for performance monitoring and team feedback. A sample of routine data collection was audited prior to (n=20) and at the end of the intervention (n=20).
Results: Six clinicians participated in this quality improvement project. Preliminary audit data suggest percentage change improvements in (1) completed Occupational Therapy home environment screening (+7%), (2) completed cognitive screening (+20%) and (3) provision of education aligned to return to work (+100%). Additionally, completion of functional assessment increased by 29% (selfcare) and 38% (hot drink preparation). This project is still underway; full results (n=470) will be analysed for presentation following completion of the implementation period (30/04/2023).
Conclusion: A multifaceted quality improvement intervention developed based on the KTAF was feasible to implement and led to improvements in occupational therapists’ adherence to the stroke guidelines in a busy acute-care unit.