JCPSLP
Volume 16, Number 1 2014
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the evidence-based recommendations but you seek more
detailed information on the efficacy of specific KTE
interventions to assist you to implement the evidence.
Searching for the evidence
A systematic search was conducted from a variety of
databases including Web of Science, CINAHL, Medline,
PubMed, SpeechBITE and the Cochrane Database using
search terms: (speech language patholog* OR speech
patholog* OR speech therap*) AND (implementation OR
knowledge translation OR knowledge transfer and
exchange OR practice change OR behaviour change
intervention). Additionally, search terms also included
aphasia, rehabilitation, swallowing, and communication.
The search was limited to articles published in English in the
last decade (2003 – October 2013). Abstracts were
reviewed according to these inclusion criteria: all study
designs (although narrative reviews were excluded), speech
pathologists as participants, KTE interventions where the
primary purpose was to translate research into clinical
practice with quantitative or qualitative outcomes being
examined at the clinician, client or service level.
Clinical bottom line
Table 1 contains a list of speech pathology focused studies
as well as a comprehensive overview of KTE interventions
used to address a clinical problem, and review evidence for
these particular KTE interventions (phase v).
Scenario
You are an experienced clinician working in an adult
rehabilitation setting with a large staff. Your recent stroke
audit demonstrated that 72% of clients on your caseload
received a speech pathology assessment within 48 hours
of admission but only 52% receive the recommended
number of hours of communication and swallowing treatment
according to the National Stroke Foundation (NSF)
recommendations (National Stroke Foundation, 2010).
Response to this scenario
You are aware of the guideline recommendations for
intensity of treatment and agree with them. However, some
on your team are not confident providing communication
therapy and identify a lack of time to develop treatment
materials in the absence of packaged evidence-based
therapy programs. You also have staffing pressures and
your department contributes to a variety of multidisciplinary
teams. You now need to research your evidence-based
options for improving your implementation of these NSF
recommendations. You are aware of general KTE
frameworks and models to guide your implementation of
KNOWLEDGE CREATION
Knowledge
Inquiry
Knowledge
Synthesis
Tools
Tailor knowledge
Identify clinical
problem
Identify, review &
select knowledge
Sustain
knowledge use
Evaluate
outcomes
of use
Monitor
knowledge use
Adapt
knowledge
locally
Assess barriers/
facilitators
Select, tailor,
implement
interventions
ACTION CYCLE
Figure 1. The Knowledge-to-Action-Process Framework.
Source: From Graham et al. (2006). Lost in knowledge translation: Time for a map?
Journal of Continuing Education in the Health Professions
,
26
,
13–24. Reproduced and adapted with permission.
