Athletic Trainers’ Methods for Determining Return to Activity for Patients With an Ankle Sprain Part II: Influences of Selected Outcomes

Author(s):  
Ryan S. McCann ◽  
Ashley M.B. Suttmiller ◽  
Phillip A. Gribble ◽  
Julie M. Cavallario

Athletic trainers’ reasons for selecting or avoiding certain evaluation techniques for patients with an ankle sprain are not fully understood. Such information is important to facilitating evidence-based practice and eliminating barriers. The purpose of this qualitative study was to determine what factors influence athletic trainers’ selection or avoidance of specific outcomes used to determine patients’ return to activity readiness following an ankle sprain. Participants cited many factors that facilitate and inhibit their use of best-practice recommendations and alternative methods for evaluating patients with ankle sprains. Athletic trainers’ should continue to promote facilitators and eliminate barriers to the use of best practices.

Author(s):  
Ryan S. McCann ◽  
Ashley M.B. Suttmiller ◽  
Phillip A. Gribble ◽  
Julie M. Cavallario

Athletic trainers are commonly responsible for clearing patients with ankle sprains for return to activity. What criteria athletic trainers typically use to determine return to activity readiness in this population remains unclear. The purpose of this qualitative study was to examine criteria athletic trainers use to determine patients’ return to activity readiness following an ankle sprain. Participants varied in selected clinician-, patient-rated, and functional assessments for patients with ankle sprains. As many selected methods did not agree with expert consensus recommendations, more work is likely needed to instill best practices for evaluation of patients with ankle sprains.


Author(s):  
Patrick L. Rowe ◽  
Adam L. Bryant ◽  
Kade L. Paterson

Abstract Background Ankle sprains are the most commonly reported injury in netball. Approximately four in five netball athletes will sustain an ankle sprain, up to half will go on to sustain recurrent ankle sprains, and nine in ten report perceived ankle instability. Historically, prevention and management strategies of ankle sprains and injuries have been investigated for a variety of sports, however, no literature reviews have investigated these in netball athletes, or compared these with current best-practice within the literature. Therefore, this scoping review aims to understand how netball athletes currently prevent and manage ankle sprains and to compare these approaches with best-practice recommendations. Methods A literature search was conducted using MEDLINE, CINAHL, and SPORTDiscus databases using keywords to capture studies with data or information related to the prevention and management of ankle sprains and injuries in netball. Results The search strategy captured 982 studies across all databases, with 30 netball studies included in this scoping review. Studies suggest netball athletes are not commonly referred to health professionals, do not undertake adequate rehabilitation, and almost immediately return to court following an ankle sprain or injury. Current best-practices suggest injury prevention programs and external ankle support effectively reduce ankle sprains and injuries; however, poor compliance and implementation may be a significant barrier. Currently, there is a lack of evidence that netball-specific footwear reduces the risk of ankle sprains. Conclusion The findings suggest netball athletes do not implement current best-practice prevention and management strategies following an ankle sprain. This is despite evidence of the effectiveness of injury prevention programs, external ankle support, and adequate rehabilitation in reducing ankle sprain rates. Current-best practice prevention and management of ankle sprains should be considered by clinicians, coaches, and athletes to reduce the prevalence and chronicity of ankle sprains in netball.


Author(s):  
Andria Hanbury ◽  
Hannah Wood

Purpose This paper aims to develop a behavioural science informed communication strategy aimed at health professionals and patients promoting best practice recommendations regarding the use of specialist liquid medicines for elderly people with swallowing difficulties. Design/methodology/approach The medicine prescribing, formulation and administration related challenges and experiences of health professionals and elderly patients with swallowing difficulties were identified through a pragmatic literature search. Key findings across the papers were synthesised into themes, before being linked to domains from a behavioural science framework. Published recommendations for behaviour change techniques that can be used to target the domains were then mapped to the domains. Guidance on how to develop a communication strategy, drawing on the insight gained from the literature review and the behavioural science recommendations, and designed to stimulate change in health-care professionals’ and patients’ behaviours, was then developed. Findings In total, 13 themes emerged across 15 papers, including “patient and health professional roles and remits”. These themes were linked to nine domains from the framework, highlighting the range of individual, social and environmental factors influencing patients’ and health professionals’ perceptions and experiences. A summary table, mapping the domains and underpinning themes to recommended behaviour change techniques, was used to develop the subsequent communication strategy recommendations. Recommendations include using techniques such as providing social processes of encourage, pressure and support to change patients’ and health professionals’ perceptions of their roles/responsibilities in medicines prescribing and administration, delivered via, for example, an educational leaflet and/or online training. Practical implications The summary table and guidance can inform development of an evidence-based strategy for communicating best practice recommendations regarding the use of liquid medicines for elderly patients with swallowing difficulties, tailored to the perceptions and challenges identified. Originality/value The behavioural science approach is less established within the pharmaceutical industry for promotion of best practice recommendations and related products, yet it offers a framework for an evidence-based and systematic approach that goes beyond a literature review or focus group.


2018 ◽  
Vol 34 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Gabrielle Rocque ◽  
Ellen Miller-Sonnet ◽  
Alan Balch ◽  
Carrie Stricker ◽  
Josh Seidman ◽  
...  

Although recognized as best practice, regular integration of shared decision-making (SDM) approaches between patients and oncologists remains an elusive goal. It is clear that usable, feasible, and practical tools are needed to drive increased SDM in oncology. To address this goal, we convened a multidisciplinary collaborative inclusive of experts across the health-care delivery ecosystem to identify key principles in designing and testing processes to promote SDM in routine oncology practice. In this commentary, we describe 3 best practices for addressing challenges associated with implementing SDM that emerged from a multidisciplinary collaborative: (1) engagement of diverse stakeholders who have interest in SDM, (2) development and validation of an evidence-based SDM tool grounded within an established conceptual framework, and (3) development of the necessary roadmap and consideration of the infrastructure needed for engendering patient engagement in decision-making. We believe these 3 principles are critical to the success of creating SDM tools to be utilized both within and outside of clinical practice. We are optimistic that shared use across settings will support adoption of this tool and overcome barriers to implementing SDM within busy clinical workflows. Ultimately, we hope that this work will offer new perspectives on what is important to patients and provide an important impetus for leveraging patient preferences and values in decision-making.


Author(s):  
Scott N. Drum ◽  
Bryanne N. Bellovary Y ◽  
Randall L. Jensen ◽  
Maggy T. Moore ◽  
Lars Donath

Author(s):  
Forrest Shull ◽  
Raimund Feldmann ◽  
Michelle Shaw ◽  
Michelle Lambert

For capturing and transferring knowledge between different projects and organizations, the concept of a Best Practice is commonly used. A similar but more general concept for knowledge capturing is often referred to as a Lesson Learned. Both best practices and lessons learned are frequently organized in the form of knowledge collections. Such collections exist in many forms and flavours: From simple notes on a white board, to paper file collections on a shelf, to electronic versions filed in a common folder or shared drive, to systematically archived and standardized versions in experience and databases, or even specific knowledge management systems. In the past few decades, many organizations have invested much time and effort in such specific knowledge collections (e.g., databases, experience repositories) for best practices and/ or lessons learned. The driving force behind all these activities is to disseminate knowledge about proven solutions to their workforce. Ultimately, the goal is to avoid mistakes and improve the overall workflow and processes to possibly save money and gain a competitive advantage.


2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 43-43
Author(s):  
Nabeela Ratansi ◽  
Aimee Langan ◽  
Irene Blais ◽  
Erin Svara ◽  
Karla Houser ◽  
...  

43 Background: As part of the Ministry’s Health System Funding Reform initiative, Cancer Care Ontario is tasked to develop and implement Quality-Based Procedures (QBPs) for programs such as GI Endoscopy and Colposcopy. QBPs are clusters of patients with clinically related diagnoses or treatments that have been identified by an evidence-based framework as providing opportunity for improving quality outcomes and reducing costs. As stated by the Ministry, the goal is to reimburse providers for the types and numbers of patients treated, using evidence-informed rates associated with the quality of care delivered. Methods: QBPs are multiyear and have four key deliverables: Clinical: developing clinical best practices. Funding: tying best practices to pricing. Capacity Planning: understanding procedure types/volumes for capacity management. Monitoring/Evaluation: measuring the QBP’s impact. Developing the QBPs has involved: Creating Clinical Expert Advisory Groups (CEAG) of clinicians who are recognized for their knowledge and expertise. Tasking the CEAG to define quality and develop best practices informed by literature reviews, jurisdictional scans, and guidelines. Documenting these standards and clinical pathways in a clinical handbook, providing information on the practices that should be implemented to ensure consistent care delivery. The development of best practices is imperative to the foundation of the QBP and spans multiple years. Once best practice development is complete, it will be tied to pricing, where the procedure will be micro-costed based on workload, equipment, supplies, and other administrative costs. Results: The QBPs continue to evolve and aim to: Reduce practice variation. Improve patient outcomes. Improve system accountability. Improve cost-effectiveness of services. Effectiveness will be measured through a performance management framework, including an integrated QBP scorecard measuring appropriateness, access, and efficiency. Conclusions: The underpinning for moving towards an evidence-based, patient-based funding model involves defining quality standards and clincal best practices, and applying these guidelines to determine the cost of quality care.


2016 ◽  
Vol 25 (3) ◽  
pp. 280-287 ◽  
Author(s):  
William M. Adams ◽  
Yuri Hosokawa ◽  
Robert A. Huggins ◽  
Stephanie M. Mazerolle ◽  
Douglas J. Casa

Context:Evidence-based best practices for the recognition and treatment of exertional heat stroke (EHS) indicate that rectal thermometry and immediate, aggressive cooling via cold-water immersion ensure survival from this medical condition. However, little is known about the recovery, medical follow-up, and return to activity after an athlete has suffered EHS.Objective:To highlight the transfer of evidenced-based research into clinical practice by chronicling the treatment, recovery, and return to activity of a runner who suffered an EHS during a warm-weather road race.Design:Case study.Setting:Warm-weather road race.Participant:53-y-old recreationally active man.Intervention:A runner’s treatment, recovery, and return to activity from EHS and 2014 Falmouth Road Race performance.Main Outcomes:Runner’s perceptions and experiences with EHS, body temperature, heart rate, hydration status, exercise intensity.Results:The runner successfully completed the 2014 Falmouth Road Race without incident of EHS. Four dominant themes emerged from the data: predisposing factors, ideal treatment, lack of medical follow-up, and patient education. The first theme identified 3 predisposing factors that contributed to the runner’s EHS: hydration, sleep loss, and lack of heat acclimatization. The runner received ideal treatment using evidence-based best practices. A lack of long-term medical care following the EHS with no guidance on the runner’s return to full activity was observed. The runner knew very little about EHS before the 2013 race, which drove him to seek knowledge as to why he suffered EHS. Using this newly learned information, he successfully completed the 2014 Falmouth Road Race without incident.Conclusions:This case supports prior literature examining the factors that predispose individuals to EHS. Although evidence-based best practices regarding prompt recognition and treatment of EHS ensure survival, this case highlights the lack of medical follow-up and physician-guided return to activity after EHS.


Crisis ◽  
2011 ◽  
Vol 32 (6) ◽  
pp. 319-333 ◽  
Author(s):  
Christina M. van der Feltz-Cornelis ◽  
Marco Sarchiapone ◽  
Vita Postuvan ◽  
Daniëlle Volker ◽  
Saska Roskar ◽  
...  

Background: Evidence-based best practices for incorporation into an optimal multilevel intervention for suicide prevention should be identifiable in the literature. Aims: To identify effective interventions for the prevention of suicidal behavior. Methods: Review of systematic reviews found in the Pubmed, Cochrane, and DARE databases. Steps include risk-of-bias assessment, data extraction, summarization of best practices, and identification of synergistic potentials of such practices in multilevel approaches. Results: Six relevant systematic reviews were found. Best practices identified as effective were as follows: training general practitioners (GPs) to recognize and treat depression and suicidality, improving accessibility of care for at-risk people, and restricting access to means of suicide. Although no outcomes were reported for multilevel interventions or for synergistic effects of multiple interventions applied together, indirect support was found for possible synergies in particular combinations of interventions within multilevel strategies. Conclusions: A number of evidence-based best practices for the prevention of suicide and suicide attempts were identified. Research is needed on the nature and extent of potential synergistic effects of various preventive activities within multilevel interventions.


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