Using the RE-AIM and TDF frameworks to evaluate the implementation of a standardized cognitive assessment protocol in outpatient rehabilitation.
Carla Tierney-Hendricks, Megan E Schliep, Minsi Sun and 2 others
PMID 39158202WHAT IT FOUND
A standardized cognitive assessment protocol was used in 71% of patient records at one outpatient site and 54% at another.
Occupational therapists adopted it much less than speech-language pathologists. Site A used leadership checks and audits, while Site B relied only on training and templates.
Key findings
01Adoption of the cognitive assessment protocol was significantly higher at Site A (71%) compared to Site B (54%), with occupational therapy adoption at Site B being particularly low (19%).
02The site that achieved higher overall adoption employed organizational-level strategies like leadership engagement and audit feedback, whereas the lower-adoption site used only individual-level strategies like training and templates.
03Clinicians perceived the protocol as effective for improving workflow efficiency and providing concrete data to support clinical decision-making and referrals.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was a post-hoc evaluation of an implementation that had already begun, so strategies were mapped retrospectively rather than tested prospectively. Data were collected over only a 3-month period, so long-term maintenance of the protocol was not assessed. The two sites were within the same health network but differed significantly in size and staffing, which may have influenced adoption rates. One focus group with OTs at Site B lasted only 15 minutes due to availability, potentially limiting the depth of data from that group. The study did not measure patient outcomes, only clinician adoption and perceptions.
Declared interests
The authors report no conflicts of interest. No external funding supported this work.
The easy way to misread this
Do not interpret the higher adoption rates as evidence that the protocol improved patient cognitive outcomes. The study measured only whether clinicians documented the assessment, not whether patients benefited. Additionally, the differences in adoption between sites may be due to pre-existing site characteristics and staffing levels rather than the specific implementation strategies alone.
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 →