Why Do We Need a New Clinical Practice Guideline for Moderate to Severe Traumatic Brain Injury?

J Head Trauma Rehabil

Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) and Université de Montréal, Montreal, Quebec, Canada (Dr Swaine); Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute/University Health Network, Toronto, Ontario, Canada (Dr Bayley and Ms Kua); Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Dr Bayley); Ottawa Hospital Research Institute (OHRI) and University of Ottawa, Ontario, Canada (Dr Marshall); Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Université Laval, Quebec City, Quebec, Canada (Mss Marier-Deschênes and Allaire and Dr Lamontagne); Ontario Neurotrauma Foundation (ONF), Toronto, Ontario, Canada (Ms Kagan); Institut national d'excellence en santé et en services sociaux (INESSS), Québec, Canada, Canada (Dr Truchon); Lawson Health Research Institute, St Joseph's Health Care, London, Ontario, Canada (Ms Janzen); and St Joseph's Health Care, University of Western Ontario, London, Ontario, Canada (Dr Teasell).

Published: October 2019

Objective: Clinical practice guidelines (CPGs) aim to improve quality and consistency of healthcare services. A Canadian group of researchers, clinicians, and policy makers developed/adapted a CPG for rehabilitation post-moderate to severe traumatic brain injury (MSTBI) to respond to end users' needs in acute care and rehabilitation settings.

Methods: The rigorous CPG development process began assessing needs and expectations of end users, then appraised existing CPGs, and, during a consensus conference, produced fundamental and priority recommendations. We also surveyed end users' perceptions of implementation gaps to determine future implementation strategies to optimize adherence to the CPG.

Results: The unique bilingual (French and English) CPG consists of 266 recommendations (of which 126 are new recommendations), addressing top priorities for MSTBI, rationale, process indicators, and implementations tools (eg, algorithms and benchmarks).

Conclusion: The novel approach of consulting and working with end users to develop a CPG for MSTBI should influence knowledge uptake for clinicians wanting to provide evidence-based care.

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Source
http://dx.doi.org/10.1097/HTR.0000000000000427DOI Listing

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