Measuring practice gaps in the delivery of evidence-based seating assessments: a retrospective chart review

Abstract

Purpose

To measure if a knowledge-to-practice gap exists between desired practice and current practice in wheelchair assessment after the implementation of a new seating assessment tool at a university affiliated rehabilitation centre.

Methods

A 6-month retrospective chart review of 61 wheelchair assessments was undertaken to determine if the assessment was consistent with a newly implemented and evidence-based seating assessment tool. Descriptive statistics were used to analyse the data to determine the degree of completion of the 69-item assessment and across 61 individual assessments.

Results

Of the 61 assessments reviewed, 69% were documented using the new seating assessment tool, 21% were documented using the previous seating assessment tool, and 10% were not documented on any seating assessment tool. Completion of the 69-item assessment tool was greater than 80% in 39% of the 61 assessments. The highest rates of completion were in the categories of patient information, clinical reasoning, and goals with an average completion of 73%, 71% and 65% respectively. The categories of linear measurements, mat assessment in supine, and postural alignment in wheelchair had the lowest average completion of 45%, 40% and 30% respectively.

Conclusion

This chart review successfully identified and quantified areas of wheelchair assessment documented in adherence to current evidence-based guidelines, as well as gaps in assessment practice that should be addressed.

Implication for rehabilitation

• Completion of chart review is a simple tool to describe current practice and evaluate adherence to practice standards.

• Identifying practice gaps is an important first step in determining areas of focus in the improvement of clinical care.

• Ongoing support and monitoring is required in the development and implementation of evidence-based wheelchair assessment to ensure adoption in clinical practice.

Keywords:

• wheelchair assessment
• occupational therapy
• knowledge translation
• evidence-based practice

Disclosure statement

No potential conflict of interest was reported by the authors.