A total performance score for inpatient rehabilitation facilities

Abstract

- To identify quality domains rehabilitation stakeholders consider the most important - To identify the percentage of an Inpatient Rehabilitation Total Performance Score that should represent the voice of the patient or their family - To identify the percentage of an Inpatient Rehabilitation Total Performance Score that should reflect what happened during the inpatient rehabilitation stay versus after the stay. We conducted a two-stage on-line survey of rehabilitation stakeholders. The surveys was completed on-line. To date, 29 respondents completed both surveys. Respondents were former inpatient rehabilitation patients, patient advocates, rehabilitation clinicians, rehabilitation researchers. Not Applicable. Rating of quality measure domains, percentage of a inpatient rehabilitation Total Performance Score that should represent the patient's voice, percentage of a inpatient rehabilitation Total Performance Score that should reflect care during the inpatient stay. To date, 29 individuals completed both surveys (72% response rate), including 17 former patients and advocates and 12 clinicians, administrators, and researchers. When presented with the Donabedian model, respondents slightly favored outcome measures compared to process and structure measures. Among the 22 quality measure topics described, respondents considered the most important quality measures to be: discharge to the community, goal setting, discharge planning, functional assessment and goals, Improvement in mobility, new or worsened pressure ulcers/injuries (undesirable outcome). When asked what percentage of a Total Performance Score should represent the voice of the patient or their family, the mode was 30%. When asked what percentage of a Total Performance Score should reflect what happened during the inpatient rehabilitation stay versus after the stay, the mode was 75%. Survey respondents supported quality measures in all three domains of the Donabedian model, slightly favoring outcome measures compared to process and structure measures. Respondents indicated that the patient's voice is important to consider in a inpatient rehabilitation Total Performance Score (mode = 30% weight) and indicated that care during the inpatient setting should be weighted more (mode = 75%) than the post-discharge (mode = 25%) time frame. Funding: RTI International