The gap between evidence and practice is real. Indeed it is estimated that it takes an average of 17 years for only 14% of research findings to be adopted into clinical practice (Westfall et al, 2007). Clearly there is a need to help frontline clinicians more effectively incorporate evidence into their daily practice. In order to address this need, Physiotherapy Services at Providence Health Care created a practice support structure in 2002 which included the Research, Education and Practice Coordinator (PT REPC -0.7 FTE). The REPC supports 120 physiotherapists and 40 rehabilitation assistants across 6 sites (incorporating acute, rehabilitation and extended care settings) to:
(1) participate in clinically relevant research,
(2) access continuing education relevant to the specific needs
(3) obtain resources, which are current and evidence-based, to guide practice and
(4) access mentoring to provide care for complex patients.
The role is currently filled by an individual with postgraduate education and experience in evidence-informed practice and knowledge translation. The REPC works collaboratively with the Physiotherapy Leadership infrastructure (Professional Practice Leader, PT Site Leaders and Clinical Specialists) and is responsible for identifying, coordinating, delivering and evaluating research, education and professional practice needs for the staff.
The impact of the physiotherapy practice support team and more specifically the REPC role was evaluated by the completion of an online questionnaire. The survey revealed: 82.9% reported that the REPC role has a moderate or significant impact on their clinical practice; 87.8% attended education provided by the REPC; 75.6% have used a resource developed by the REPC; 68.3% have requested information from the REPC and 61.5% have received help from the REPC in enhancing skills in evidence-informed practice. Comments revealed that the role clearly enhanced their clinical practice and their confidence that they were providing the ‘best’ care to their patients/residents.
With respect to tangible research outcomes, the following metrics have been realized since the inception of the role: 14 research projects, approximately $700,000 of funding from agencies such as CIHR and MSFHR, participation of 28 PHC frontline physiotherapists and 5 publications in peer-reviewed professional journals. Moreover, multiple evidence-informed guidelines have been developed for diverse patient populations including: post-operative mastectomy protocols, inpatient and outpatient amputee care guidelines, recommendations re use of hip protectors in residential settings and appropriate utilization of incentive spirometry in the general surgery population. These resources have subsequently been requested and utilized by other health care authorities/organizations.
This role has successfully facilitated multiple projects, with participation by each of these stakeholder groups, which has resulted in successful grant funding, publication and most importantly integrated knowledge translation that has enabled the results to be implemented into daily practice to provide best practice for a wide spectrum of the patient and resident population. Moreover, many of the projects undertaken and resources developed have involved interdisciplinary colleagues from nursing, occupational therapy, social work, respiratory therapy and medicine. As a consequence, we are able to provide best care, based on evidence and research, to our patients and residents.
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