Implementation

A major goal of the Academy of Orthopaedic Physical Therapy (AOPT) is to provide for the interchange and dissemination of information about current trends and practices related to orthopaedic physical therapy (PT). As a means to accomplish this goal, the AOPT has sponsored the creation and development of Clinical Practice Guidelines (CPGs). The purpose of CPGs is to describe evidence based PT practice, classify and define common musculoskeletal conditions, and identify interventions supported by best current evidence to address impairment, functional limitation, and disability. Essentially CPGs are a one-stop shop for best care practices, and every physical therapist treating patients with orthopaedic conditions should be familiar with CPGs in their practice area.

The AOPT is committed to the implementation of CPGs in real-world clinics. Implementation science is the study of methods to promote the adoption and integration of evidence-based practices, interventions and policies into routine health care and public health settings. Implementation research plays an important role in identifying barriers to, and enablers of, effective global health programming and policymaking, and leveraging that knowledge to develop evidence-based innovations in effective delivery approaches (source: https://www.fic.nih.gov/researchtopics/pages/implementationscience.aspx) .To promote this effort, the AOPT co-sponsored the Implementation Science Institute and a Workshop focused on CPG implementation projects with the Center on Health Services Training and Research (CoHSTAR). The first conference and workshop was held in Providence, RI, and a second conference is being planned for the Spring of 2020. As well, the small grants program at AOPT is available to investigators interested in studying the implementation of CPGs. More information about grants can be found here.

To date, the AOPT has developed 12 CPGs and related implementation resources like decision trees, patient education handouts, videos, etc, which can all be found here.  Suggestions for new CPGs are welcome and can be made here: https://www.surveymonkey.com/r/CPGtopicnomination.

Resources, tools, and articles related to Implementation and Planning for Implementation:

• Orientation to Dissemination and Implementation Research in Health Resource Guide:
  • https://cancercontrol.cancer.gov/IS/docs/Orientation-to-DI-Research-in-Health-Resource-Guide.pdf
  • https://www.fic.nih.gov/researchtopics/pages/implementationscience.aspx
• CoHSTAR Institute:
  • http://www.bu.edu/cohstar/training/
• Example of Barriers/facilitators from National Cancer Institute:
  • https://cancercontrol.cancer.gov/IS/training-education/orientation.html.
  • https://cancercontrol.cancer.gov/IS/docs/Orientation-to-DI-Research-in-Health-Resource-Guide.pdf  
• SQUIRE guidelines for reporting on quality improvement:
  • https://qualitysafety.bmj.com/content/17/Suppl_1/i13
• Journal specific to Implementation related articles and research:
  • https://implementationscience.biomedcentral.com/
• Translating scientific knowledge into action (Knowledge into Action: K2A) guide:
  • https://www.cdc.gov/chronicdisease/pdf/k2a-framework-6-2015.pdf
• From https://www.academyhealth.org/sites/default/files/orientation_to_di_science.pdf:
  • https://www.queri.research.va.gov/implementation: QUERI Implementation Guide Members of the IRG developed a comprehensive implementation guide, which includes information on applying frameworks, theories, and models, designing an intervention, implementation methods, formative evaluation, and tools and toolkit.