The seventh #ResNetSLT tweet-chat of 2019 will take place on Wednesday 31st July 7:30-8:30 (UK Time) and will be hosted by Elicia Jones @EllieJSLT and Sophie Chalmers @SChalmersSLT.
The tweet-chat will be based around this paper: Implementation—The Missing Link in the Research Translation Pipeline: Is It Any Wonder No One Ever Implements Evidence-Based Practice? By Elizabeth Lynch, Brigit Chesworth and Louise Connell. PLEASE NOTE that this paper is not full open access, but our discussions will follow the summary and question prompts below.
The paper focuses on the available evidence to guide the implementation of evidence to practice in stroke rehabilitation, however it’s also relevant to other areas of Speech and Language Therapy. The paper highlights that despite growth in the evidence base, there is still a paucity of knowledge about how to deliver evidence-based stroke rehabilitation therapies in clinical practice consistently and sustainably. This means that many stroke survivors do not receive recommended evidence-based rehabilitation treatments.
The paper presents a review of the literature to explore how much research is being done to improve the use of evidence-based treatments in stroke rehabilitation. It shows there is little new knowledge being generated about how to ensure stroke survivors receive evidence-based rehabilitation and shows a pressing need to develop and evaluate new strategies to apply the evidence we already have, so that we can improve the health and wellbeing of stroke survivors/patients/clients.
Although the proposed paper for the tweet chat focuses on stroke rehabilitation, we welcome Speech and Language Therapists from all fields and other allied health professionals to contribute to the chat focussing on the following questions:
- What examples can you share from your team of translating research into practice, and what resources did you use to support this? (e.g. NICE guidelines, QI initiatives)
- What was your experience of sustaining the evidence-based practice changes that you’d implemented?
- How did you evaluate the practice changes? And at what time points did you measure practice?
- What would help you to develop a more positive culture around evidence-based practice implementation?
- Do you feel confident to implement evidence-based practice in your field? (Twitter POLL)
HERE’S THE SUMMARY OF THE CHAT …
The summary from the tweet chat is sectioned under each question:
A1. Examples of translating research into practice and resources
The main themes that came from the twitter chat included:
- Using NICE guidelines to inform specific disease pathways within a therapy service
- Disseminating research at team meetings; covering one topic per month/term
- Implementation resources on the NICE website https://www.nice.org.uk/about/what-we-do/into-practice/implementing-nice-guidance
- Creating own research and implementing as this will be directly targeted
- Disseminating a regular research bulletin using various sources and working closely with trust libraries
- Use of RCSLT EBP and implementation resources on website for members
A2. Experience of sustaining evidence–based practice changes
Examples that were shared within the tweet chat included:
- EBP prompt sheet created by a service
- Integrating evidence into policies and pathways to sustain change over time
- Joining a program e.g. research champions to keep EBP on your personal agenda
- Resources such as http://horizonsnhs.com/
- Organising in house study days to disseminate up to date research knowledge and implementation
- Attending and get involved in networking within trusts, regionally, nationally and within CENs
- Setting up journal alerts for implementation science to find evidence to inform practice
- Often think about the parallels of marketing and scale up with dissemination and implementation.
- Ensure there is a plan for reflection and review – with a named person who will take responsibility for this
- Model good practice and make conversation to ensure slow change
A3. Evaluating practice changes
- Plan evaluation practices from the outset
- RCSLT members can get involved with the RCSLT outcomes programmes (ROOT)
- Obtain advice, support (and space) early on to make sure evaluation measure are measuring what you want and what commissioners want
- Work towards goal based outcomes to measure impact
- Maintain interest to current/usual practice and what’s sustaining it
- Getting other stakeholders involved in measuring change also valuable e.g. Measure of Processes of Care Tool
- Resource for Implementing and monitoring interventions in early years: https://borninbradford.nhs.uk/wp-content/uploads/An-implementation-Monitoring-Toolkit_V0.pdf
- Resource: “The FRAME: an expanded framework for reporting adaptation and modifications to evidence-based interventions (Stirman, Baumann & Miller) https://implementationscience.biomedcentral.com/articles/10.1186/s13012-019-0898-y
A4. Developing a positive culture around evidence–based practice implementation
- Top down approach – the importance managers place on EBP and research activities is key
- Help creating an action plan relevant to implementation
- Think about the parallels of marketing and scale up with dissemination and implementation.
- Lots of strategies to help implementation in clinical practice e.g. pre-appraisal resources sources, rapid review skills – advice and workshops at RCSLT conference