Evidence-based practice, because of its potential to improve patient care, has become a priority in the healthcare system and is clearly the way of the future. Medicine has a long history of relying on anecdotal experiences, which runs the danger of promoting practices that are ineffective, inefficient, and in some cases, produce less than optimal outcomes. Evidence-based practice is therefore an increasingly important element of clinical care.
The delivery of rehabilitation is typically done by a rehabilitation clinician/team on a one-on-one basis. The fact that therapy is delivered on a one-on-one basis means that there are other factors, other than the actual treatment, which will influence the outcomes (Banja 1997). The chronic and ever-evolving nature of many patients’ conditions makes it difficult to decide the optimum amount of therapy at the outset of treatment (Purtillo 1992). The experience, enthusiasm and empathy of the rehabilitation clinician still plays an extremely important role in the rehabilitation of patients with ABI but these qualities are difficult to fully capture within the structure of evidence-based practice. Further, ABI rehabilitation outcomes reflect a process in which various decisions are made by different stakeholders. These stakeholders consider what is desirable, acceptable, reasonable, and appropriate, and how these decisions produce an outcome to which subjective assessments of worth or value will be attached (Banja 1997).