Semin Speech Lang 2018; 39(01): 037-052
DOI: 10.1055/s-0037-1608857
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Implementing a Standardized Assessment Battery for Aphasia in Acute Care

Sofia Vallila-Rohter
1   Department of Communication Sciences and Disorders, MGH-Institute of Health Professions, Boston, Massachusetts
2   Speech and Swallow Department, Brigham and Women's Hospital, Boston, Massachusetts
,
Laura Kasparian
2   Speech and Swallow Department, Brigham and Women's Hospital, Boston, Massachusetts
,
Olga Kaminski
2   Speech and Swallow Department, Brigham and Women's Hospital, Boston, Massachusetts
,
Megan Schliep
1   Department of Communication Sciences and Disorders, MGH-Institute of Health Professions, Boston, Massachusetts
,
Semra Koymen
2   Speech and Swallow Department, Brigham and Women's Hospital, Boston, Massachusetts
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
22. Januar 2018 (online)

Abstract

In this article, the implementation of a standardized assessment battery for the evaluation of language in an acute care setting is described. Following an institutional shift to adopt electronic medical records, researchers and clinicians worked together to develop a technology-assisted evaluation of aphasia that would be used to assess all patients admitted to our facility with stroke. The project goal was to devise a clinical process to improve aphasia diagnosis and evaluation while remaining feasible within constraints imposed by the acute care setting and the electronic medical record. Utilizing frameworks from implementation science, the four key phases were: (1) initial considerations of the host setting, (2) creation of a structure for implementation, (3) maintenance of this structure once implementation began, and (4) improvement for future applications. A pilot implementation demonstrated that establishing and executing a minimum standardized assessment for aphasia in acute care is feasible. Retrospective medical record review of 50 aphasia evaluations in the setting of first incidence of left hemisphere stroke affecting the middle cerebral artery (25 preimplementation and 25 postimplementation) revealed that information content of medical notes was more consistent and complete postimplementation than preimplementation. Clinical implications and future directions are discussed.

 
  • References

  • 1 Centers for Disease Control and Prevention. Stroke facts. Available at: http://www.cdc.gov/stroke/facts.htm . Accessed September 6, 2017
  • 2 Berthier ML. Poststroke aphasia: epidemiology, pathophysiology and treatment. Drugs Aging 2005; 22 (02) 163-182
  • 3 Pedersen PM, Vinter K, Olsen TS. Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc Dis 2004; 17 (01) 35-43
  • 4 El Hachioui H, Lingsma HF, van de Sandt-Koenderman MW, Dippel DW, Koudstaal PJ, Visch-Brink EG. Long-term prognosis of aphasia after stroke. J Neurol Neurosurg Psychiatry 2013; 84 (03) 310-315
  • 5 Lazar RM, Speizer AE, Festa JR, Krakauer JW, Marshall RS. Variability in language recovery after first-time stroke. J Neurol Neurosurg Psychiatry 2008; 79 (05) 530-534
  • 6 Vogel AP, Maruff P, Morgan AT. Evaluation of communication assessment practices during the acute stages post stroke. J Eval Clin Pract 2010; 16 (06) 1183-1188
  • 7 Garland AF, Kruse M, Aarons GA. Clinicians and outcome measurement: what's the use?. J Behav Health Serv Res 2003; 30 (04) 393-405
  • 8 Bayley MT, Hurdowar A, Richards CL. , et al. Barriers to implementation of stroke rehabilitation evidence: findings from a multi-site pilot project. Disabil Rehabil 2012; 34 (19) 1633-1638
  • 9 Potter K, Fulk GD, Salem Y, Sullivan J. Outcome measures in neurological physical therapy practice: part I. Making sound decisions. J Neurol Phys Ther 2011; 35 (02) 57-64
  • 10 Stevens JG, Beurskens AJ. Implementation of measurement instruments in physical therapist practice: development of a tailored strategy. Phys Ther 2010; 90 (06) 953-961
  • 11 Meyers DC, Durlak JA, Wandersman A. The quality implementation framework: a synthesis of critical steps in the implementation process. Am J Community Psychol 2012; 50 (3–4): 462-480
  • 12 Eccles MP, Mittman BS. Welcome to implementation science. Implement Sci 2006; 1 (01) 1
  • 13 NIRN. Implementation science defined. National Implementation Research Network. 2017. Available at: http://nirn.fpg.unc.edu/learn-implementation/implementation-science-defined . Accessed September 1, 2017
  • 14 Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care 2012; 50 (03) 217-226
  • 15 Flamand-Roze C, Falissard B, Roze E. , et al. Validation of a new language screening tool for patients with acute stroke: the Language Screening Test (LAST). Stroke 2011; 42 (05) 1224-1229
  • 16 Azuar C, Leger A, Arbizu C, Henry-Amar F, Chomel-Guillaume S, Samson Y. The Aphasia Rapid Test: an NIHSS-like aphasia test. J Neurol 2013; 260 (08) 2110-2117
  • 17 Enderby PM, Wood VA, Wade DT, Hewer RL. The Frenchay Aphasia Screening Test: a short, simple test for aphasia appropriate for non-specialists. Int Rehabil Med 1987; 8 (04) 166-170
  • 18 Enderby P, Crow E. Frenchay Aphasia Screening Test: validity and comparability. Disabil Rehabil 1996; 18 (05) 238-240
  • 19 Nakase-Thompson R, Manning E, Sherer M, Yablon SA, Gontkovsky SL, Vickery C. Brief assessment of severe language impairments: initial validation of the Mississippi aphasia screening test. Brain Inj 2005; 19 (09) 685-691
  • 20 Doesborgh SJ, van de Sandt-Koenderman WM, Dippel DW, van Harskamp F, Koudstaal PJ, Visch-Brink EG. Linguistic deficits in the acute phase of stroke. J Neurol 2003; 250 (08) 977-982
  • 21 Goodglass H, Barresi B. Boston Diagnostic Aphasia Evaluation: Short Form Record Booklet. New York, NY: Lippincott Williams & Wilkins; 2000
  • 22 Goodglass H, Kaplan E, Barresi B. Boston Diagnostic Aphasia Examination—Third Edition (BDAE-3). Austin, TX: Pro-Ed; 2000
  • 23 Kertesz A. The Western Aphasia Battery. Philadelphia, PA: Gruyne & Stratton; 1982
  • 24 Lang CE, Bland MD, Connor LT. , et al. The brain recovery core: building a system of organized stroke rehabilitation and outcomes assessment across the continuum of care. J Neurol Phys Ther 2011; 35 (04) 194-201
  • 25 Bland MD, Sturmoski A, Whitson M. , et al. Clinician adherence to a standardized assessment battery across settings and disciplines in a poststroke rehabilitation population. Arch Phys Med Rehabil 2013; 94 (06) 1048-53.e1
  • 26 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
  • 27 Jansen AC, van Aalst-Cohen ES, Hutten BA, Büller HR, Kastelein JJ, Prins MH. Guidelines were developed for data collection from medical records for use in retrospective analyses. J Clin Epidemiol 2005; 58 (03) 269-274