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Exploring organizational characteristics associated with practice changes following a mentored online educational
Susan Rappolt1, Kristine Pearce, Sara McEwen
1Department of Occupational Therapy, University of Toronto, Toronto, Ontario, Canada. s.rappolt@utoronto.ca
Summary
Hospital resources and organizational structures significantly impact rehabilitation professionals' ability to implement evidence-based practices. Investing in computer access, dedicated time, and supportive environments enhances practice changes in stroke care.
Area of Science:
- Health Services Research
- Clinical Practice Improvement
- Rehabilitation Medicine
Background:
- Organizational factors are critical determinants of evidence-based practice adoption by healthcare professionals.
- Previous studies highlight the influence of structural and resource characteristics on research utilization in clinical settings.
- This pilot study investigates the relationship between hospital resources and self-reported practice changes among rehabilitation professionals.
Purpose of the Study:
- To compare health professionals' self-reported practice changes with organizational characteristics supporting research use.
- To identify specific hospital structures and resources associated with successful implementation of evidence-based practices in stroke rehabilitation.
Main Methods:
- Analysis of self-reported practice changes from stroke rehabilitation professionals participating in the Rehabilitation Education Program for Stroke (REPS).
- In-depth interviews with REPS mentors and managers to assess participating hospitals' structural and resource characteristics.
- Quantitative comparison of coded hospital data with the percentage of participants reporting positive practice changes.
Main Results:
- Hospitals with higher reported practice improvements offered better computer access and paid time for the educational intervention.
- Favorable organizational factors included established specialized stroke units, strong teamwork, and a prior commitment to best practices.
- Hospitals engaging in program audits, evaluations, and 'bottom-up' decision-making demonstrated greater practice change.
Conclusions:
- The capacity of healthcare organizations to support practice changes is crucial when designing educational interventions for rehabilitation professionals.
- Future research should utilize objective measures to further examine the link between organizational characteristics and practice improvements post-intervention.
- Continuing education providers must consider organizational readiness to maximize the impact of professional development programs.