International Clinical Guidelines at the American University of Beirut, Physical Therapy Department: Strategy of Implementation and Evaluation

Abstract

Purpose. The purpose of the study is (1) to describe the selection process of an international clinical guideline (CGL) for patients with low back pain (LBP) for adoption and implementation at the Physical Therapy Department at the American University of Beirut Medical Center (AUBMC), and (2) to evaluate the physiotherapists’ compliance. Method. International guidelines were identified through a literature search and compared according to the AGREE instrument for selection. Quality indicators were selected. Physiotherapists were educated about guidelines’ benefits and the content of the adopted guidelines during interactive sessions; patients’ files were optimized and audited in order to evaluate compliance. Results. Out of six guidelines for LBP, we selected that of the Royal Dutch Association of Physiotherapy. Full adherence of physiotherapists to the educational sessions was noted. A total of 72 patient files were available. However, only 23 out of 72 files (32%) were complete to test the therapists’ adherence to the new assessment forms using 13 quality indicators. A high level of compliance with a mean score of 90% was recorded for the diagnostic process indicators, and a low level for the mean score of therapeutic process indicators (42%) except the indicator for the advice to stay active (100%). The mean score for the outcome of care was very low (13%). Conclusions. Dutch guidelines for low back pain were selected for adoption and implementation. A relatively high level of adherence to guidelines recommendations was noticed in the diagnostic process and a low level in the therapeutic process.