International Journal of Clinical Case Reports, 2025, Vol.15, No.2, 90-97 http://medscipublisher.com/index.php/ijccr 93 deterioration has shown that while monitoring has improved, errors in scoring and non-adherence to referral protocols remain problematic (Odell, 2015). This suggests that integrating new tools with existing protocols requires careful planning and alignment with current practices. Additionally, the implementation of the interRAI AC assessment system highlighted the need for interoperability with other information systems to ensure smooth integration and effective use. The challenges of working within existing practice procedures and assessment protocols were also noted in a study on the implementation of a multimodal program for patients with mild cognitive impairment, emphasizing the need for comprehensive system engagement (Nemoto et al., 2018). 4.3 Limitations of current assessment tools Current assessment tools also have inherent limitations that can affect their implementation and effectiveness. Many tools are not universally applicable and may not suit every clinical setting. For instance, a review of nursing workloads and activity in critical care found that no single tool is likely to suit every application, and more information is needed to clarify the practicalities of using these tools (Greaves et al., 2018). Additionally, the systematic review of clinical assessment for undergraduate nursing students highlighted the need for a holistic clinical assessment tool with a reasonable level of validity and reliability, as current tools often lack these qualities (Wu et al., 2015). The inconsistency among assessment methods and tools between countries and institutions further complicates the development of standardized and reliable assessment practices (Immonen et al., 2019). Moreover, the integration of patient-centered communication tools, such as the Interactive Tailored Patient Assessment (ITPA), revealed that while these tools offer benefits, they also present new challenges for nurses, including organizational challenges and the need for training in communication skills (Børøsund et al., 2014). 5 Case Study: Implementation of a Rapid Assessment Tool in Stroke Units 5.1 Background of the case study The implementation of rapid assessment tools in stroke units is crucial for improving patient outcomes and streamlining clinical workflows. Stroke units often face challenges in timely and accurate assessment of patients, which can impact the quality of care and recovery. This case study focuses on the application of a rapid assessment tool designed to enhance the efficiency and effectiveness of stroke rehabilitation. 5.2 Methodology of implementation The methodology for implementing the rapid assessment tool involved several key steps. Initially, a comprehensive toolkit of standardized measurement tools was developed, drawing from evidence-based practices and existing frameworks such as the Knowledge-to-Action Framework. The implementation process was collaborative and iterative, involving clinicians and leaders in co-developing the plan and addressing barriers through targeted interventions. Training sessions were conducted to ensure clinician adherence and familiarity with the new tools (Murphy et al., 2017). The toolkit included various assessments such as the Berg Balance Scale, 10 Meter Walk Test, and 6 Minute Walk Test, among others (Table 1) (Moore et al., 2020). 5.3 Results and observations The implementation of the rapid assessment tool yielded significant improvements in clinical practice. Initial adherence to the assessment protocols was moderate but increased substantially over time. For instance, adherence to the gait assessment battery (GAB) rose from 46% to over 85% within six months and remained consistent for 48 months. Similarly, the use of standardized measurement tools in team meetings increased from 36% to 81% post-implementation (Tyson et al., 2015). Clinicians reported positive perceptions of the toolkit, noting improvements in problem identification, progress monitoring, and decision-making. However, some challenges were observed, such as lower adherence rates for more comprehensive scales and logistical issues during the initial implementation phase. 5.4 Lessons learned and recommendations Several lessons were learned from the implementation of the rapid assessment tool. First, the importance of a collaborative and iterative approach cannot be overstated. Engaging clinicians and leaders in the development and execution of the plan was crucial for addressing barriers and ensuring sustainability. Second, ongoing training and support are essential for maintaining high levels of adherence and clinician satisfaction. Third, while the toolkit
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