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Canadian SCI Rehabilitation Introduction

Dear Reader Like all good things in rehabilitation, this first Canadian National Atlas of SCI Rehabilitation is the product of interprofessional teamwork from a collaborative community of practice. Throughout the conception, design, implementation and reporting of the E-Scan, this project has been propelled by the genuine compassion and commitment of Canadian rehabilitation professionals to provide the best care to individuals living with the consequences of spinal cord injury. From the outset, there was consensus that SCI rehabilitation in Canada has a marketing problem – the public does not understand the philosophy, goals or interprofessional nature of the psychological, physical, medical or surgical services necessary for optimal rehabilitation service delivery. In fact, most equate the term rehabilitation to reality TV-based drug and alcohol rehab programs. Thus, prior to embarking on this project, we spent a great deal of time developing and refining a framework of SCI rehabilitation, in order to communicate the individualized, goal oriented and multimodal nature of rehabilitation service delivery. Our intent was to ensure that the goals and processes of rehabilitation care are self-evident. Before delving into the content of the E-Scan, please take a few moments to familiarize yourself with this framework. A brief national overview of the age, gender and injury of individuals with SCI, in Canada, and the duration of time spent in inpatient rehabilitation settings, are presented in the chapter, “What does the E-Scan tell us about SCI Rehabilitation In Canada?” These components provide the reader with an overview of where SCI rehabilitation occurs, who is served in SCI rehabilitation programs, and what these programs are all about. Having developed the rehabilitation framework, we then sought to provide an accurate picture of the current Canadian SCI rehabilitation landscape, by conducting a scoping review. This is scientific speak for, “We used a variety of sources of information to describe current trends and gaps in SCI rehabilitation services in Canada”. Data sources included published clinical practice guidelines, recent systematic reviews, care maps, local hospital care protocols; administrative, hospital utilization and billing data; clinical leaders, and nationally or internationally-recognized Canadian SCI content experts. For readers with scientific or epidemiological expertise, the scoping review methods are described, in considerable detail, in The SCI Rehabilitation Framework, Modified Scoping Review Methods, and Report Card Decoding chapters; as well as a publication in the Journal of Spinal Cord Medicine. The strength of the scoping review is the breadth of perspectives provided. The scoping review results are reported as they relate to specific rehabilitation goals. Each chapter includes a short explanation of the rehab goal, a description of the current model of SCI service delivery (including the type and number of healthcare professionals and their related resources), and the key outcome measures and references used to inform current practice. Chapters contain a meaningful discussion of what is good, bad or ugly about current practice. 4 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


Canadian SCI Rehabilitation Introduction
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