Using scoping review methods to describe current capacity and prescribe change in Canadian SCI rehabilitation service delivery

Abstract

Objective: To describe the methodology used to conduct a scoping review of spinal cord injury (SCI) rehabilitation service delivery in Canada, and to explain the reporting process intended to advance future service delivery. Evidence acquisition: A SCI rehabilitation framework derived from the International Classification of Function, Disability and Health was developed to describe the goals and interprofessional processes of rehabilitation. An adapted Arksey and O'Malley (2005) methodological framework was used to conduct a scoping review of SCI rehabilitation services in Canada. Data were obtained from multiple relevant sources via survey (N = 3572 data fields) from 13 of 15 Canadian tertiary SCI rehabilitation sites, systematic reviews, white papers, literature reviews, clinical practice resources, and clinicians. Multidisciplinary teams of content experts (n = 17), assisted with data interpretation and validation by articulating practice trends, gaps, and priorities. Evidence synthesis: The findings will be presented in an atlas, which includes aggregate national data regarding impairment and demographic characteristics, service utilization, available resources (staff and capital equipment), specialized services, local expertise, and current best practice indicators, outcome measures, and clinical guidelines. Data were collated and synthesized relative to specific rehabilitation goals. The current state of SCI rehabilitation service delivery (specific to each rehabilitation goal) is summarized in a report card within three domains, knowledge generation, clinical application, and policy change, and specifies key 2020 priorities. Conclusion: These findings should prompt critical evaluation of current Canadian SCI rehabilitation service delivery while specifying enhancements in knowledge generation, clinical application and policy change domains likely to assist with achievement of best practices by 2020. The net result of these barriers to information exchange is the absence of a prior comprehensive account of SCI rehabilitation service delivery in Canada. The Rehabilitation Environmental Scan (E-Scan) project is part of a translational research program intended to describe current SCI rehabilitation service delivery in Canadian tertiary rehabilitation centers and to create a related national dataset. This manuscript seeks to describe the methodology used to conduct a scoping review of SCI rehabilitation services in Canada and explain the atlas reporting process intended to inform and advance future SCI rehabilitation service delivery. Methods Defining the research questionThe primary objective of this scoping review was to describe current SCI rehabilitation services for individuals with subacute and chronic SCI admitted to 13 tertiary SCI rehabilitation sites in Canada. This objective was defined by the investigators following discussion with the members of the rehabilitation arm of the SCI Solutions Translational Research Network, a national group of scientists and clinical thought leaders, frustrated by th...

Outcomes and reflections on a consensus-building workshop for developing a spinal cord injury-related chronic pain research agenda

“…In Canada, progress in this area includes recent investments by the Canadian Federal and Provincial branches of Government to the Rick Hansen Institute's "Care Program" 81 that has funded a number of research and knowledge translation activities with clear linkages at the research, clinical, and policy levels. [82][83][84][85] These resources elevates the SCI research field's ability to easily access information and/or tools to better address pain, which may be of use to help inform the wide range of information needs of people with SCI and their family members and caregivers. In general, there has been a clear gain in the number of research studies in the area of pain, but the ability to generalize findings into clinical practice remains problematic.…”

Development of Cardiometabolic Health indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project

“…The selection of Cardiometabolic Health as a Domain of interest for developing indicators emerged from the environmental scan (E-Scan) consensus-building activity designed to select the broader set of Domains. 26 This process involved a systematic search to collect information about SCI/D rehabilitation care related to Cardiometabolic Health and factors that influence the outcome of rehabilitation interventions and a scoping synthesis of the acquired data. Medline and Embase databases were searched using the terms "cardiometabolic health", "spinal cord injury", or both.…”

The Tipping Point: Perspectives on SCI Rehabilitation Service Gaps in Canada

“…The atlas represents an amalgamation of a national data set describing current rehabilitation resources and service delivery, results of a scoping review, and the expert opinion of 46 coauthors, and 86 collaborators from 15 tertiary SCI rehabilitation centres across the nation regarding the current state of SCI rehabilitation knowledge generation, clinical application, and policy change in Canada. An overall framework for understanding the rehabilitation process is presented in the atlas [13]; summary data from the scoping review is presented throughout the atlas as it relates to specific goals of rehabilitation (i.e., maintaining skin integrity or developing independence in breathing). Intended for use by multiple stakeholders (clinicians, administrators, non-governmental organizations, etc.…”

“…), the atlas attempts to: facilitate program self-evaluation and service enhancements; articulate future research and health policy agendas; and inform accreditation processes and best practice implementation. Through the scoping review methodology employed by the authors [13], the atlas identified national trends, gaps (regional and/or process disparity) and priorities in SCI rehabilitation service delivery. This article presents key national perspectives derived from the scoping review process that warrant international reflection and dialogue.…”