Rehabilitation indicators
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
Erzsébet Boros
Erika Takács Health Services Management Training Centre Semmelweis University, Budapest
Literature review
USA
UK
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
AUSTRALIA
HUNGARY
R Guile at all. Validation of a tool assessing appropriateness of hospital days in rehabilitation centres. International Journal for Quality in Health Care, 2009
UK
Suggested process indicators
Waiting times
–
Referral to assessment
Assessment to admission
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
–
Assessment to admission
–Provision of equipment
Length of stay
Set of defined goals for each patient
At least one outcome measure recorded on
UK
Suggested outcome indicators
Single concept outcome measures
–% discharged home
% returned to work
–
% returned to work
Scales
–
Validated instruments for measurement of
disability and/or handicap
(depend on the patient’s condition and disability, their rehabilitation needs, and the nature of the programme)
Australasian rehabilitation indicators
1.
No functional assessment within seven working days of
admission
2.
No functional assessment before cessation of an inpatient
rehabilitation program
rehabilitation program
3.
No appropriate discharge plan on separation
4.
Unplanned interruption to rehabilitation program
5.Rehabilitation patient deaths
6.
Rehabilitation patient deaths audit
7.
No multidisciplinary rehabilitation plan within seven
Rehabilitation indicators - Hungary
Rehabilitation Professional Advisory Board
Patient death
Unplanned patient transfer
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
Unplanned patient transfer
Participation on team meeting
Patient death audit
Functional assessment at admission and before
discharge
Candidate indicators for PATH
1.
Rehabilitation in-patient death
2.
Audit of rehabilitation patient death
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
Audit of rehabilitation patient death
3.
Functional assessment at admission and prior to
discharge
4.
Multidisciplinary rehabilitation plan
5.
Unplanned interruption to rehabilitation program
6.Length of stay
1. Rehabilitation in-patient deaths
Patients admitted to a rehabilitation unit/facility would not
normally be expected to die (unless as a consequence of a
normal disease process)
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
– Numerator
Total number of rehabilitation patient death within the rehabilitation unit
– Denominator
Total number of patients within and admitted to a rehabilitation unit
– Dimensions: Appropriate, Safe – Desirable level: Low
2
. Audit of rehabilitation patient death
All inpatient deaths should be addressed through an internal audit process/quality improvement study
Numerator
Total number of rehabilitation patient deaths adressed
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
Total number of rehabilitation patient deaths adressed within an audit process/quality improvement study
Denominator
Total number of rehabilitation patient death within the rehabilitation unit/facility
Dimension: Effective Desirable level: High
3/A Functional assessment at admission
The implementation of an effective rehabilitation program is dependent upon the early assessment of patient function.
Numerator:
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
Numerator:
Total number of patients admitted to a rehabilitation
unit/facility for whom there is documented evidence of a functional assessment within defined working days of patient admission
Denominator:
Total number of patients admitted to the rehabilitation
unit/facility with a minimum length of stay of defined working days Dimension: appropriate
3/B Functional assessment prior to discharge
Functional assessment prior to separation is a useful tool to ensure adequate discharge planning and to minimize the risk of patient
readmission
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
Numerator:
Total number of patients for whom there is documented evidence of a functional assessment prior to cessation of an active inpatient
rehabilitation program Denominator
Total number of inpatients who cease an active inpatient rehabilitation program
Dimension: appropriate Desirable level: high
4. Multidisciplinary rehabilitation plan
Multidisciplinary rehabilitation plan is nessesary within defined working days of admission
The establishment of a rehabilitation plan with regular review is necessary for effective patient rehabilitation
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
Numerator
Total number of patients admitted to a rehabilitation unit/facility for whom there is documented established mutidisciplinary rehabilitation plan within defined working days of patient admission
Denominator
Total number of patients admitted to a rehabilitation
unit/facility with a minimum length of stay of defined working days.
5. Unplanned interruption to rehabilitation program
Any unplanned interruption may significantly impact upon treatment outcomes
This indicator serves as a flag for interruption to a rehabilitation
program and also serves as a flag for further analysis.
The second PATH'09 International Workshop, Krakow, 26-27 oct, 2009
program and also serves as a flag for further analysis.
Numerator
Total number of patients having an unplanned interruption to their rehabilitation program
Denominator
Total number of patients commenced on a rehabilitation program
Dimension: Effective
6.
Length of stay
Duration of the length of stay depends on the
patient’s needs
Nominator:
summation of patients-days during the
last year
Denominator:
number of patients during the last
year
Dimension: appropriate
Questions
What is the current practice in your country in
connection with rehabilitation indicators? Is there
data collection for rehabilitation indicators?
What kind of indicators are developed and/or used in
your country?
Is your country interested in rehabilitation indicators
in PATH'09 project?
How many hospitals would join data collection for
rehabilitation indicators?
