Use of the iPRISM webtool in a learning community to assess implementation context and fit of a novel clinical decision support tool for physical therapy triage in acute care hospitals.
Joshua K Johnson, Jennifer L Sullivan, Katy E Trinkley and 5 others
PMID 38934486WHAT IT FOUND
Clinicians and researchers co-designed a hospital triage tool and surveyed their own readiness to use it.
They identified organizational culture and inconsistent triage workflows as the main barriers to adoption, leading to a planned educational strategy for future implementation.
Key findings
01The learning community identified organizational culture and existing variations in triage methods as the primary barriers to implementing the new decision support tool.
02Adoption was rated as the least likely RE-AIM outcome to be achieved, with specific concern about whether staff who use the tool would differ from those who decline it.
03The team developed a multicomponent implementation strategy focused on educational materials, ongoing consultation, and executive involvement, rather than mandating use.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a pre-implementation study; no patient outcomes or actual tool effectiveness in practice were measured. The iPRISM survey was completed only by the 10 LC partners, who were heavily involved in the design, potentially biasing their perception of fit and barriers. The cross-walk between PRISM and CFIR frameworks is novel and not validated. The study did not collect demographics for the LC members, so it is unclear if they represent the broader therapist population. The final statistical model variables are proprietary and not fully reported.
Declared interests
Funded by a pilot grant from the Learning Health System Rehabilitation Research Network (LeaRRn), supported by NIH. One author reports grant support from the National Cancer Institute. The proprietary status of the tool is under review by Cleveland Clinic Innovations, which may limit future reporting of model details.
The easy way to misread this
Do not assume the PT-PENCIL tool improves patient outcomes or discharge rates. This paper only describes the preparation for its use; the effectiveness study is planned for a future phase.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →