Despite the availability of standardized assessments in stroke rehabilitation, occupational therapy (OT) practitioners do not routinely implement these assessments in real-world practice. In response to this knowledge-to-practice gap, rehabilitation researchers and clinicians teamed up to optimize the implementation of standardized assessments – the Fugl-Meyer Assessment and Action Research Arm Test – with stroke survivors in the acute, inpatient, and outpatient stroke rehabilitation at The Ohio State University Wexner Medical Center. 

Step 1: Conduct needs assessment. Key informants (three OTs, one      physical therapist, and three rehabilitation administrators) indicated that the Fugl-Meyer Assessment and Action Research Arm Test were important to implement across the rehabilitation continuum; however, targeted efforts were needed to overcome barriers to assessment implementation. Our research team conducted a scoping review to understand these implementation barriers specific to stroke rehabilitation and OT. We applied the Consolidated Framework for Implementation Research (CFIR) and identified three main barriers: a lack of access to knowledge and information, limited communication networks, and unsupportive implementation culture. 

Step 2: Select and tailor implementation strategies. Our team entered our three main implementation barriers into the CFIR-ERIC (Expert Recommendations for Implementing Change project) matching tool, which recommended we deploy the following strategies to overcome implementation barriers: conduct educational meetings, create a learning collaborative, and identify and prepare champions. We further vetted these strategies in formal focus groups with OT practitioners in acute, inpatient, and outpatient rehabilitation settings. They requested three additional implementation strategies to support the Fugl-Meyer Assessment and Action Research Arm Test use: develop (web-based) educational materials, provide necessary equipment, and change record systems. 

Step 3: Deploy implementation strategies. We have deployed the following strategies as of April 2022: Appointing one assessment “champion” at each setting (e.g., acute, inpatient, outpatient) to serve as a liaison between the project team and frontline OTs; providing all OTs with necessary equipment to implement both the Fugl-Meyer Assessment and Action Research Arm Test; collaborating with the information technology (IT) department to change electronic medical records allowing for streamlined documentation of assessments in stroke survivors’ medical charts; conducting in-person training with OTs (n = 26); and providing e-training materials. 

Step 4: Evaluate strategies. Our team is collaborating with the rehabilitation IT department to pull monthly chart data and determine the extent to which our implementation strategies improve the use of standardized assessments by OT practitioners. Our goal is to improve assessment use from 3.5% to 85% across the stroke continuum by August 2023.