Knowledge Contribution for the OT Practitioner: Stroke Clinical Decision Supports

Capstone Catalog
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I partnered with OT Potential to develop stroke clinical decision supports for the OT practitioners working in the acute, subacute, and chronic phases of stroke rehabilitation.

Student name: Ella Vanderpool
Name of Mentor: Sarah Lyon, OTR/L
School: University of Wisconsin, Madison
Capstone setting: OT Potential
Virtual / In-person / Hybrid: Virtual

Capstone Objectives: This capstone project seeks to translate the evidence-based AJOT stroke best-practice guidelines into an accessible menu of information for OTPs working in stroke rehabilitation. The various phases (acute, subacute, and chronic) each provide a bank of relevant assessments, interventions, goals, and education resources that are based in research.

Method/Design/Approach: Over the course of the 14-week capstone, I worked to develop three clinical decision support guides for OT Practitioners working in acute, subacute, and chronic stroke rehabilitation, patient handouts that address complex motor recovery theories, and publish a public-facing patient stroke treatment guide for OT Potential. These CDS resources follow a template created by OT Potential. They include Possible Assessments, Possible Goal Areas, Possible Treatment Interventions, Discharge Suggestions, Education Resources for Patients & Practitioners, and Patient Handouts.

My mentor sought out connections with experts to guide this process, including Chris Gaskins (PhD, OTR/L, CSRS) and Rachel Proffitt (OTD, OTR/L, FAOTA, FACRM). The primary sources include the AJOT Stroke Practice Guidelines (Hildebrand, Geller, and Proffitt, 2023) to inform the intervention component, and the Canadian Stroke Best Practice Recommendations to inform the assessments. Chris Gaskins wrote goals for each area (Functional Capacity and ADLs/iADLs; Motor Function; Mobility; Upper Extremity; Mood & Cognition; Visual Perception & Neglect; and Spasticity) and each rehabilitative phase (acute, subacute, chronic).

Results/Outcomes: OT Potential Club members reported a high effectiveness of the Chronic Stroke CDS to inform their practice. There was an average rating of 90% likelihood to utilize this CDS.

For the public, I also served as the lead author on this treatment guide:

Conclusions: Stroke clinical decision support guides provide real-time support for OT practitioners, bridging the gap between evidence-based stroke rehabilitation research & practice.

2-3 ideas for future directions to build on on this project:

  1. Expand source of literature to include additional assessments, interventions, and goal areas.
  2. Incorporate feedback from OT Potential Club members.
  3. Review and update resources as new information becomes available.

Reflections on how you see this project influencing your OT career trajectory:
I feel honored to have worked with my site mentor, Sarah Lyon, to create these resources that will serve as a guide for both OT practitioners and stroke survivors. This experience gave me further insight and respect for the tedious work that is required to translate research into tangible practice. I am excited to see how these resources continue to evolve over time and will use this knowledge to inform my own practice and professional career.

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I can’t believe we did this! (And, that pages like this didn’t already exist!)

Google sheets for the win in helping to distill all of the information out there! And, special thanks to @christopher3 @rachel25 @daniel2 and @alana1 and @sarah36 for making this project possible!

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