Using scoping review methods to describe current capacity and prescribe change in Canadian SCI rehabilitation service delivery

Abstract

Objective

To describe the methodology used to conduct a scoping review of spinal cord injury (SCI) rehabilitation service delivery in Canada, and to explain the reporting process intended to advance future service delivery.

Evidence acquisition

A SCI rehabilitation framework derived from the International Classification of Function, Disability and Health was developed to describe the goals and interprofessional processes of rehabilitation. An adapted Arksey and O'Malley (2005) methodological framework was used to conduct a scoping review of SCI rehabilitation services in Canada. Data were obtained from multiple relevant sources via survey (N = 3572 data fields) from 13 of 15 Canadian tertiary SCI rehabilitation sites, systematic reviews, white papers, literature reviews, clinical practice resources, and clinicians. Multidisciplinary teams of content experts (n = 17), assisted with data interpretation and validation by articulating practice trends, gaps, and priorities.

Evidence synthesis

The findings will be presented in an atlas, which includes aggregate national data regarding impairment and demographic characteristics, service utilization, available resources (staff and capital equipment), specialized services, local expertise, and current best practice indicators, outcome measures, and clinical guidelines. Data were collated and synthesized relative to specific rehabilitation goals. The current state of SCI rehabilitation service delivery (specific to each rehabilitation goal) is summarized in a report card within three domains, knowledge generation, clinical application, and policy change, and specifies key 2020 priorities.

Conclusion

These findings should prompt critical evaluation of current Canadian SCI rehabilitation service delivery while specifying enhancements in knowledge generation, clinical application and policy change domains likely to assist with achievement of best practices by 2020.

Keywords:

• Disability
• Spinal cord injuries
• Clinical practice
• Rehabilitation
• Scoping review
• Service delivery

Acknowledgements

Funding and infrastructure support to enable data collection for this project was provided by the Rick Hansen Institute. The authors acknowledge the support of the Toronto Rehabilitation Institute, which receives funding under the Provincial Rehabilitation Research Program from the Ministry of Health and Long-Term Care in Ontario. The views expressed do not necessarily reflect those of the Ministry. The authors thank Carey Yada-Lee of RHI for her graphic design assistance, and John Cobb and Heather Askes for their support with the data collection and storage process.

The authors wish to thank their many colleagues in each of the participating sites who contributed to the data collection and cleaning process.

Conflict of interest statement

The Rick Hansen Institue employs three of the authors (Noonan, Cherban, and Raschid). The remaining authors declare no conflict of interest.