Tailoring the Recovery Ruler: A Data Visualization Tool for Disorders of Consciousness Rehabilitation Programs

Authors

Patricia Grady-Dominguez, Colorado State University, Fort Collins, CO.
Lauren Teague, Colorado State University, Fort Collins, CO.
Alison McGuire, The George Washington University, Washington DC.
Jasmine Tran, Bella Vista Health Center, Lemon Grove, CA.
Katherine O'Brien, TIRR Memorial Hermann Hospital, Houston, TX.
Kelsey Watters, Shirley Ryan Ability Lab, Chicago, IL.
Kristen Sheau, Spaulding Rehabilitation Hospital, Charleston, MA.
Candace Tefertiller, Colorado State University, Fort Collins, CO; The George Washington University, Washington DC; Bella Vista Health Center, Lemon Grove, CA; TIRR Memorial Hermann Hospital, Houston, TX; Shirley Ryan Ability Lab, Chicago, IL; Spaulding Rehabilitation Hospital, Charleston, MA; Craig Hospital, Englewood, CO; Lived Experience Study Team Investigators.
Kaitlin Hays, Craig Hospital, Englewood, CO.
Trisha Kot, Lived Experience Study Team Investigators.
Paige Ford, Lived Experience Study Team Investigators.
Trudy Mallinson, The George Washington University, Washington DC.
Jennifer A. Weaver, Colorado State University, Fort Collins, CO. Electronic address: jen.weaver@colostate.edu.

Document Type

Journal Article

Publication Date

1-7-2026

Journal

Archives of physical medicine and rehabilitation

DOI

10.1016/j.apmr.2025.12.028

Keywords

Consciousness Disorders; Data Visualization; Outcome Assessment; User-Centered Design

Abstract

OBJECTIVE: To describe the process and results of tailoring the Recovery Ruler, a novel data visualization tool for patients in disorders of consciousness at four post-acute rehabilitation programs. DESIGN: Descriptive, participatory, qualitative approach. We conducted iterative design sessions with rehabilitation practitioners to tailor the Recovery Ruler for post-acute care workflows. SETTING: Four post-acute rehabilitation programs. PARTICIPANTS: 16 rehabilitation practitioners. INTERVENTION: Not applicable. MAIN OUTCOME MEASURE: Transcripts from design sessions, research team notes, and correspondences to describe the process of tailoring the Recovery Ruler. RESULTS: Practitioners identified three core functions of the Recovery Ruler: (1) communicating Coma Recovery Scale-Revised (CRS-R) results to family care partners, (2) guiding interpretation of CRS-R scores, and (3) providing context for CRS-R results. Revisions to the tool aligned with these functions, including emphasizing the 0-100 equal-interval scale for clarity, replacing solid lines with dashed lines to represent score ranges, and adding fields for clinical notes and test completion codes. Practitioners perceived that tailoring the Recovery Ruler enhanced comprehensibility, efficiency and alignment with program workflows. CONCLUSIONS: The Recovery Ruler was tailored to meet the diverse needs of four post-acute DoC programs, emphasizing person-centered principles of transparency, comprehensibility, and perceptions of holistic communication. Practitioners' input guided revisions to enhance family communication, facilitate CRS-R interpretation, and contextualize patient data, while maintaining adaptability to varied clinical workflows. Future research should focus on extended usability testing and tailored implementation strategies to optimize integration into practice.

APA Citation

Grady-Dominguez, Patricia; Teague, Lauren; McGuire, Alison; Tran, Jasmine; O'Brien, Katherine; Watters, Kelsey; Sheau, Kristen; Tefertiller, Candace; Hays, Kaitlin; Kot, Trisha; Ford, Paige; Mallinson, Trudy; and Weaver, Jennifer A., "Tailoring the Recovery Ruler: A Data Visualization Tool for Disorders of Consciousness Rehabilitation Programs" (2026). GW Authored Works. Paper 8606.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8606

Department

Clinical Research and Leadership