Improving practice through collaboration: Early experiences from the multi-site Spinal Cord Injury Implementation and Evaluation Quality Care Consortium

Abstract

Context

Dedicated implementation efforts are critical to bridging the gaps between current practices and best practices. A quality improvement collaborative (QIC), the Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC), was established to meet this need, bringing together a network of clinicians and administrators to systematically improve the quality and equity of tertiary spinal cord injury or disease (SCI/D) rehabilitation care in Ontario, Canada.

Methods

Clinicians and leaders from five tertiary SCI/D rehabilitation centers and two not-for-profit SCI/D advocacy groups comprised a network dedicated to supporting implementation of the SCI-High quality indicators in prioritized domains of SCI rehabilitation and related best practices by: (1) building capacity through implementation science education of frontline clinicians; (2) providing resources and support to empower frontline clinicians to lead quality improvement efforts within their institutions; (3) promoting wider learning through a network for sharing ideas, efforts, and experiences; and (4) collecting indicator data to facilitate provincial evaluation of goal attainment.

Results

Network members and sites collaborated to implement best practices within six priority domains; in 18 months, significant progress has been made in emotional wellbeing, sexual health, walking, and wheeled mobility despite disruptions due to the COVID-19 pandemic. These efforts encompass heterogeneous challenges and strategies, ranging from developing clinical skills programs, to streamlining processes, to manipulating physical space.

Conclusion

A QIC targeting SCI/D rehabilitation demonstrates promise for advancing the implementation of best practices, building implementation science capacity across multiple sites, and for promoting collaboration amongst SCI/D rehabilitation centers and organizational partners.

Keywords:

• Spinal cord injuries
• Implementation science
• Rehabilitation
• Quality of health care
• Networks

Acknowledgements

This work represents a highly collaborative effort by numerous individuals across the participating member organizations of the SCI IEQCC (more information available at https://SCIConsortium.ca). The authors gratefully acknowledge the information provided in support of the manuscript by Rachel Holthof, MSW, RSW (Providence Care Hospital) and the graphical expertise provided by David Clark. Dr. Craven acknowledges support from the Toronto Rehab Foundation as the Toronto Rehabilitation Institute Chair in Spinal Cord Injury Rehabilitation, and receipt of consulting fees from the Rick Hansen Institute.

Disclaimer statements

Contributors None.

Funding This work would not be possible without the funding support provided by the Ontario Neurotrauma Foundation (CA) and Praxis Spinal Cord Institute (CA) through the Toronto Rehabilitation Institute [grant number 2018-RHI-HIGH-1057, Dr. Craven PI] and Lawson Health Research Institute [grant number 2018-RHI-IMPLEM-1064, Dr. Wolfe PI].

Conflicts of interest No potential conflict of interest was reported by the author(s).