Abstract
Evidence-based practice is the foundation of rehabilitation for maximizing client outcomes. However, an unacceptably high number of ineffective or outdated interventions are still implemented, leading to sub-optimal outcomes for clients. This paper proposes the Rehabilitation Evidence bAsed Decision-Making (READ) Model, a decision-making algorithm for evidence-based decision-making in rehabilitation settings. The READ Model outlines a step-by-step layered process for healthcare professionals to collaboratively set goals, and to select appropriate interventions. The READ Model acknowledges the important multi-layered contributions of client's preferences and values, family supports available, and external environmental factors such as funding, availability of services and access. Healthcare professionals can apply the READ Model to choose interventions that are evidence-based, with an appropriate mode, dose, and with regular review, in order to achieve client's goals. Two case studies are used to demonstrate application of the READ Model: cerebral palsy and autism spectrum disorder. The READ Model applies the four central principles of evidence-based practice and can be applied across multiple rehabilitation settings.
Highlights
Evidence-based practice (EBP) has become the cornerstone of care to maximize client outcomes through the application of best-available interventions
The aim of this paper is to propose a model for comprehensive evidence-based algorithmic decision-making in rehabilitation settings
The model was developed from systematic review evidence about effective: evidence-based practice implementation [8,9,10,11]; shared decision-making [18]; decision-aides [27]; and evidence-based algorithms for decision-making [28]
Summary
Evidence-based practice (EBP) has become the cornerstone of care to maximize client outcomes through the application of best-available interventions. A systematic review of preventable risk factors for Sudden Infant Death Syndrome (SIDS) published in 2005 found that earlier implementation of the supine sleeping “Back to Sleep” campaign, may have prevented at least 50,000 infant deaths in Europe, the USA, and Australasia since the 1970’s [3]. This evidence lag is likely a significant underestimation, with studies only measuring part of the evidence-to-practice process [4]. Such challenges highlight the need for well-reasoned decision-making within EBP
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