Use of the iPRISM webtool in a learning community to assess implementation context and fit of a novel clinical decision support tool for physical therapy triage in acute care hospitals

Author:

Johnson Joshua K.1234ORCID,Sullivan Jennifer L.56,Trinkley Katy E.7,Lapin Brittany489,Passek Sandra2,Asp Valerie2,Ford Bryan10,Rabin Borsika A.1011

Affiliation:

1. Department of Physical Medicine and Rehabilitation Neurological Institute, Cleveland Clinic Cleveland Ohio USA

2. Rehabilitation and Sports Therapy Neurological Institute, Cleveland Clinic Cleveland Ohio USA

3. Center for Value‐Based Care Research Community Care, Cleveland Clinic Cleveland Ohio USA

4. Department of Medicine Cleveland Clinic Lerner College of Medicine at Case Western Reserve University Cleveland Ohio USA

5. Department of Health Services, Policy, & Practice, School of Public Health Brown University Providence Rhode Island USA

6. Long Term Services and Support Center of Innovation (LTSS COIN) Veterans Administration Providence Healthcare System Providence Rhode Island USA

7. Department of Family Medicine University of Colorado Anschutz Medical Campus Aurora Colorado USA

8. Department of Quantitative Health Sciences Lerner Research Institute, Cleveland Clinic Cleveland Ohio USA

9. Center for Outcomes Research and Evaluation Neurological Institute, Cleveland Clinic Cleveland Ohio USA

10. Adult and Child Center for Outcomes Research and Delivery Science University of Colorado School of Medicine Aurora Colorado USA

11. Herbert Wertheim School of Public Health and Human Longevity Science University of California San Diego San Diego California USA

Abstract

AbstractBackgroundThe iPRISM webtool is an interactive tool designed to aid the process of applying the Practical, Robust Implementation and Sustainability Model (PRISM) for the assessment of and fit with context. A learning community (LC) is a multidisciplinary group of partners addressing a complex problem. Our LC coproduced the Physical TheraPy frEqueNcy Clinical decIsion support tooL (PT‐PENCIL) to guide the use of physical therapist services in acute care hospitals.ObjectiveTo describe our LC's activities to co‐produce the PT‐PENCIL, use of the iPRISM webtool to assess its preimplementation context and fit, and develop a multicomponent implementation strategy for the PT‐PENCIL.DesignA descriptive research design.SettingThree tertiary care hospitals.ParticipantsThirteen LC partners: six clinical physical therapists, three rehabilitation managers, three researchers, and a bioinformaticist.InterventionsNot applicable.Outcome MeasuresUsing the iPRISM webtool, expected fit of the PT‐PENCIL was rated 1 (not aligned) to 6 (well aligned) for each PRISM domain and expected reach, effectiveness, adoption, implementation, and maintenance were rated 1 (not likely at all) to 6 (very likely). Discrete implementation strategies were identified from the Expert Recommendations for Implementing Change.ResultsThe process spanned 18 meetings over 8 months. Ten LC partners completed the iPRISM webtool. PRISM domains with the lowest expected alignment were the “implementation and sustainability infrastructure” (mean = 4.7 out of 6; range = 3–6) and the “external environment” (mean = 4.9 of 6; range = 4–6). Adoption was the outcome with the lowest expected likelihood (mean = 4.5 out of 6; range = 1–6). Six discrete implementation strategies were identified and combined into a multicomponent strategy.ConclusionsWithin a LC, we used existing implementation science resources to co‐produce a novel clinical decision support tool for acute care physical therapists and develop a strategy for its implementation. Our methodology can be replicated for similar projects given the public availability of each resource used.

Funder

National Institute on Aging

Publisher

Wiley

Reference59 articles.

1. TrinkleyKE RabinBA.An interactive visual webtool to guide the pragmatic and iterative use of iPRISM. Podium Presented at: 15th Annual Conference on the Science of Dissemination and Implementation in Health Washington D.C.2022Accessed May 24 2023.https://academyhealth.confex.com/academyhealth/2022di/meetingapp.cgi/Paper/54840

2. iPRISM Webtool. Accessed February 15 2023.https://prismtool.org/

3. Post-Acute Care Reform — Beyond the ACA

4. Home, please: A conjoint analysis of patient preferences after a bad hip fracture

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