Quality Improvement in Stroke Rehabilitation: A Scoping Review

BACKGROUND: Quality improvement interventions are used extensively in health care, aiming to improve delivery and promote best practice. The impact of quality improvement interventions implemented in stroke rehabilitation remains unclear. OBJECTIVE: The aim of this scoping review is to examine the different types of published quality improvement interventions in stroke rehabilitation and their impact on improving the quality of care. MATERIALS AND METHODS: A scoping review was performed in the PubMed, Embase and CINAHL databases. QI studies evaluating interventions for stroke rehabilitation patients that were published up to August 2020 were included. The review looked at the types of quality improvement interventions that have been evaluated as well as the improvements/impacts reported for quality improvement interventions for stroke patients in rehabilitation. RESULTS: We reviewed 1580 studies, twelve quality improvement interventions met inclusion criteria and were included in the current study. Six studies involved organizational change, three studies involved provider education and audit-feedback and three studies involved provider education. Of the twelve quality improvement interventions that have been included, >90% reported improvements (91.6%). In the majority of cases, improvements were noted through implementation of a myriad of interventions. Several facilitators and barriers were noted during implementation and contributed to success or failure of the intervention. CONCLUSION: There is paucity of full-text peer-reviewed published research investigating quality improvement interventions for improving the quality of care in stroke rehabilitation. The current review offers value to healthcare providers in terms of key success factors, contextual factors, barriers and facilitators associated with improvements in stroke rehabilitation.