Enablers and Barriers on Implementing Evidence-Based Assessment Tools in Early Cerebral Palsy Detection. What Do Spanish Physical Therapists Say?

Abstract

Introduction and Aim. The use of timely and accurate assessment tools —such as the general movement assessment (GMA) and the Hammersmith Infant Neurological Examination (HINE)— is the cornerstone of early diagnosis of cerebral palsy (CP). A key step in the effective implementation of new evidence in health care is first understanding current practice and identifying factors that may help or slow change. The aim of our study was to identify possible enablers and barriers to the implementation of the recommended assessment tools (i.e. GMA and HINE) and change of practice in early intervention from the perspective of pediatric physical therapists working in Spain.
Methods. Pediatric physical therapists working in Spain in early intervention were invited to complete an electronic survey about their experiences and clinical practice of working with young children with CP. Two free-text questions relating to the responders' perceived enablers and barriers on the use of recommended assessment tools allowed for the collection of qualitative information.
Results. 140 pediatric therapists completed the survey. System factors were defined as barriers (n= 90) rather than enablers (n= 7). Of the system factors, ‘time, workload and staffing’ (n= 46), and funding (n= 28) were considered the most common barriers. ‘Collaborative teamwork, and sharing knowledge learned and experiences through multi-disciplinary teamwork’ (n= 28), and ‘health professional knowledge’ (n= 22) were the most frequently identified enablers for physical therapists in Spain.
Discussion and Conclusion. The implementation of guidelines for early detection of CP is possible when the specific characteristics of each country are considered. Information on the common barriers and enablers for the use of recommended assessment tools identified by Spanish physical therapists allows for the planning for tailored training processes, adjust knowledge translation strategies, and coordinate policies at local, regional and national levels to ensure the implementation of international guidelines for early detection of CP in Spain.