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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/31948

Title: Inter-professional Clinical Practice Guideline for Vocational Evaluation following Traumatic Brain Injury
Authors: Stergiou-Kita, Mary Melpomeni
Advisor: Rappolt, Susan
Dawson, Deirdre R.
Department: Rehabilitation Science
Keywords: clinical practice guidelines
vocational rehabilitation
traumatic brain injury
evidence-based practice
health plan implementation
return to work
employment
work capacity evaluation
brain injury
vocational evaluation
work assessment
job performance
work performance
employment status
re-employment
review
work integration
work re-integration
brain injuries
practice guideline
knowledge transfer
knowledge translation
implementation
occupational therapy
neurological rehabilitation
knowledge exchange
research utilization
continuing professional development
quality improvement
practice change
change management
health care technology
implementation research
Issue Date: 11-Jan-2012
Abstract: Due to physical, cognitive and emotional impairments, many individuals are unemployed or under-employed following a traumatic brain injury. The research evidence links the rigour of a vocational evaluation to future employment outcomes. Despite this link, no specific guidelines exist for vocational evaluations. Using the research evidence and a diverse panel of clinical and academic experts, the primary objective of this doctoral research was to develop an inter-professional clinical practice guideline for vocational evaluation following traumatic brain injury. The objective of the guideline is to make explicit the processes and factors relevant to vocational evaluation, to assist evaluators (i.e. clients, health and vocational professionals, and employers) in collaboratively determining clients’ work abilities and developing recommendations for work entry, re-entry or vocational planning. The steps outlined in the Canadian Medical Association's Handbook on Clinical Practice Guidelines were utilized to develop the guideline and include the following: 1) identifying the guideline’s objective/questions; 2) performing a systematic literature review; 3) gathering a panel; 4) developing recommendations; 4) guideline writing; 5) pilot testing. The resulting guideline includes 17 key recommendations within the following seven domains: 1) evaluation purpose and rationale; 2) initial intake process; 3) assessment of the personal domain; 4) assessment of the environment; 5) assessment of occupational/job requirements; 6) analysis and synthesis of assessment results; and 7) development of evaluation recommendations. Results from an exploratory study of the guideline’s implementation by occupational therapists in their daily practices revealed that clinicians used the guideline to identify practice gaps, systematize their evaluation processes, enhance inter-professional and inter-stakeholder communication, and re-conceptualize their vocational evaluations across disability groups. Statistically significant improvements were also noted in clients’ participation scores on the Mayo-Portland Adaptability Inventory–4 following guideline use. This guideline may be applicable to individuals with TBI, clinicians, health and vocational professionals, employers, professional organizations, administrators, policy makers and insurers.
URI: http://hdl.handle.net/1807/31948
Appears in Collections:Doctoral

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