What are Best Practices?
Consistent, standardized data improves care.
In healthcare, best practices are methods proven through research and clinical experience to be the most effective for achieving desired outcomes. One critical best practice is the consistent use of standardized outcome measures.
- Measuring impact: Before introducing any new treatment or technology, we need a reliable way to measure its effects. Standardized outcome measures provide that foundation.
- Tracking patient progress: They allow us to monitor changes in recovery for individual patients over time.
- Enabling comparisons: Using the same measures across sites makes it possible to compare outcomes between groups receiving different treatments. This helps identify what works best and allows sharing of successful approaches.
For conditions like spinal cord injury (SCI), where patient numbers are relatively low, consistent use of standardized outcome measures across Canada is especially vital. It ensures that data collected is meaningful, comparable, and can guide improvements in care and research.
Why is it Difficult to Apply Outcome Measure Best Practices?
Identifying challenges in SCI care.
Key challenges include:
- While many instruments exist, not all are relevant or sensitive for the SCI
- There is no national consensus on which measures to use and when, making it difficult to compare results across sites.
- Clinicians need training and support to perform these measures reliably and consistently. Hospitals and clinics also require the capacity to collect and store data through appropriate forms and workflows.
- To sustain continuous use, the data must be analyzed and reported back to clinicians and programs—closing the loop so that outcome measures truly inform care and drive improvement.
How is Praxis Improving Outcome Measure Best Practices?
From challenges to action: The SCI best practices trio.
Together with our SCI network, particularly our Registry network (RHSCIR), 3 priority outcome measures as best practices were identified based on their clinical and research relevance, priorities of people with SCI, and feasibility. The 3 best practices are:
- The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), the gold standard for neurological assessment of motor and sensory function after SCI;
- Standing and Walking Assessment Tool (SWAT), a comprehensive toolkit of outcome measures an individual’s functional standing and walking abilities, which is a high priority of individuals following SCI;
- The Spinal Cord Independence Measure (SCIM), a disability scale specifically for the SCI population to assess functional ability in key activities of daily living — selfcare, respiration and sphincter management, and mobility.
Our Praxis Clinical Team has supported implementation of these best practices by:
- Fostering a Community of Practice with clinical leads at Registry sites
- Providing interactive in-person training and online support for clinicians
- Developing educational resources like toolkits and training videos
- Offering access to online learning opportunities, such as the International Standards Training E-Learning Program (InSTeP)
- Helping clinicians embed outcome measures into standard practice
- Supporting data collection in the Registry and reporting results back to clinicians, programs, and individuals with SCI
- Using data for research and quality improvement initiatives to answer priority clinical questions
ISNCSCI Algorithm
The Algorithm is based on the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), determined by ASIA, which is the gold standard assessment for determining a person’s level and severity of impairment after SCI.
SWAT
Standing and Walking Assessment Tool (SWAT). Developed by the Canadian SCI Standing and Walking Measures Group, the SWAT is a comprehensive tool that incorporates five validated standing balance and walking measures along with a unique 11-point staging tool.
SCIM
Spinal Cord Independence Measure (SCIM) is a disability scale developed specifically for the SCI population to assess various activities of daily living — selfcare, respiration and sphincter management, and mobility.
Scientific Publications
See a list of Praxis’ research network publications.
SCIRE Professional
Supported by Praxis, SCIRE is a free online resource to inform health professionals and people with SCI of best rehabilitation practices.
