International journal of speech-language pathology · 2025
Does a champion-led implementation toolkit have the potential to improve aphasia guideline adherence? Results from a feasibility study.
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Shrubsole Kirstine, Levine Rachel, Lynch Elizabeth, Briffa Charmaine, Pierce John E, Trebilcock Megan, Do Chau-Anh, Wallace Sarah J, Power Emma
Аннотация
PURPOSE: Active implementation efforts are needed to reduce evidence-practice gaps in post-stroke aphasia services. One potential solution is a comprehensive toolkit incorporating evidence-based implementation tools, led by trained Change Champions. We explored the feasibility, acceptability, and potential effectiveness of a prototype toolkit to improve speech-language pathologists' practice.
METHOD: Mixed-methods, pre-post, feasibility study within one Australian health service (n = 12 speech-language pathologists). Two Change Champions completed training then selected tools to support provision of written aphasia-friendly information for 3 months. Outcome measures included: a) Pre-post medical record audits, b) pre-post behavioural-determinants surveys, and c) post-study clinician focus groups. Data were analysed using descriptive statistics and non-parametric tests for quantitative data and content analysis for qualitative data, then integrated using a convergent interactive approach.
RESULT: Clinicians perceived the toolkit was feasible and acceptable, and highlighted the benefit of Change Champions and resources in facilitating change. Post-implementation written aphasia-friendly information provision increased by 60% (p = 0.005) and most (12/14) targeted barriers improved, suggesting the toolkit with Change Champion support had the potential to improve practice.
CONCLUSION: The champion-led implementation toolkit prototype was feasible and acceptable, improving guideline-recommended aphasia care. Result support further development of a theory-informed, tailorable implementation toolkit to improve aphasia services.
METHOD: Mixed-methods, pre-post, feasibility study within one Australian health service (n = 12 speech-language pathologists). Two Change Champions completed training then selected tools to support provision of written aphasia-friendly information for 3 months. Outcome measures included: a) Pre-post medical record audits, b) pre-post behavioural-determinants surveys, and c) post-study clinician focus groups. Data were analysed using descriptive statistics and non-parametric tests for quantitative data and content analysis for qualitative data, then integrated using a convergent interactive approach.
RESULT: Clinicians perceived the toolkit was feasible and acceptable, and highlighted the benefit of Change Champions and resources in facilitating change. Post-implementation written aphasia-friendly information provision increased by 60% (p = 0.005) and most (12/14) targeted barriers improved, suggesting the toolkit with Change Champion support had the potential to improve practice.
CONCLUSION: The champion-led implementation toolkit prototype was feasible and acceptable, improving guideline-recommended aphasia care. Result support further development of a theory-informed, tailorable implementation toolkit to improve aphasia services.