Effect and process evaluation of implementing standardized tests to monitor patients in spinal cord injury rehabilitation

Abstract

Purpose. To evaluate the implementation of standardized physical and functional tests to monitor patients with a spinal cord injury (SCI) in eight rehabilitation centers and to analyze the enablers and the barriers of the implementation process.

Method. The method involved prospective effect and process evaluation. Team members responded to mailed questionnaires at the start (n = 115) and end (n = 82) of the 1-year implementation period. Furthermore, a questionnaire was administered to managers (n = 8), coordinators (n = 8), and 32 persons with SCI in four centers. Outcome of the effect evaluation was the phase of implementation of standardized testing in each center. The process evaluation analyzed enablers and barriers of the implementation process.

Results. After a year of implementation, half of the centers shifted to higher implementation phases. None of the centers was classified in the highest phase. Enablers were the positive attitude of the team members regarding standardized testing and an encouraging local coordinator. Most important barrier was lack of time to implement the standardized testing.

Conclusion. There is a large support for implementing standardized tests to monitor patients with SCI. During the 1-year, a positive shift was visible in the extent of implementation. Successful implementation of patient monitoring requires substantial amounts of time and effort of the rehabilitation centers involved.

Keywords:

• Spinal cord injury
• outcomes

Acknowledgements

The authors thank the team members, patients, coordinators and managers of the eight participating rehabilitation centers: De Hoogstraat, Utrecht; Rehabilitation Center Amsterdam, Amsterdam; Het Roessingh, Enschede; Rijndam Revalidatiecentrum, Rotterdam; Hoensbroeck Revalidatiecentrum, Hoensbroek; Sint Maartenskliniek, Nijmegen; Center for Rehabilitation Beatrixoord, Haren; and Heliomare, Wijk aan Zee. This study was supported by the Dutch Health Research and Development Council, ZON-MW Rehabilitation program, grant no. 1435.0037 and 1435.0045.

Note

1. www.fbw.vu.nl/onderzoek/A4zon/ZONenglish/index.htm