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Postacute rehabilitation quality of care: toward a shared conceptual framework.

Publication ,  Journal Article
Jesus, TS; Hoenig, H
Published in: Arch Phys Med Rehabil
May 2015

There is substantial interest in mechanisms for measuring, reporting, and improving the quality of health care, including postacute care (PAC) and rehabilitation. Unfortunately, current activities generally are either too narrow or too poorly specified to reflect PAC rehabilitation quality of care. In part, this is caused by a lack of a shared conceptual understanding of what construes quality of care in PAC rehabilitation. This article presents the PAC-rehab quality framework: an evidence-based conceptual framework articulating elements specifically pertaining to PAC rehabilitation quality of care. The widely recognized Donabedian structure, process, and outcomes (SPO) model furnished the underlying structure for the PAC-rehab quality framework, and the International Classification of Functioning, Disability and Health (ICF) framed the functional outcomes. A comprehensive literature review provided the evidence base to specify elements within the SPO model and ICF-derived framework. A set of macrolevel-outcomes (functional performance, quality of life of patient and caregivers, consumers' experience, place of discharge, health care utilization) were defined for PAC rehabilitation and then related to their (1) immediate and intermediate outcomes, (2) underpinning care processes, (3) supportive team functioning and improvement processes, and (4) underlying care structures. The role of environmental factors and centrality of patients in the framework are explicated as well. Finally, we discuss why outcomes may best measure and reflect the quality of PAC rehabilitation. The PAC-rehab quality framework provides a conceptually sound, evidence-based framework appropriate for quality of care activities across the PAC rehabilitation continuum.

Duke Scholars

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Published In

Arch Phys Med Rehabil

DOI

EISSN

1532-821X

Publication Date

May 2015

Volume

96

Issue

5

Start / End Page

960 / 969

Location

United States

Related Subject Headings

  • Rehabilitation
  • Recovery of Function
  • Quality of Life
  • Quality of Health Care
  • Physical Therapy Modalities
  • Patient-Centered Care
  • Patient Satisfaction
  • Patient Discharge
  • Outcome and Process Assessment, Health Care
  • Humans
 

Citation

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Jesus, T. S., & Hoenig, H. (2015). Postacute rehabilitation quality of care: toward a shared conceptual framework. Arch Phys Med Rehabil, 96(5), 960–969. https://doi.org/10.1016/j.apmr.2014.12.007
Jesus, Tiago Silva, and Helen Hoenig. “Postacute rehabilitation quality of care: toward a shared conceptual framework.Arch Phys Med Rehabil 96, no. 5 (May 2015): 960–69. https://doi.org/10.1016/j.apmr.2014.12.007.
Jesus TS, Hoenig H. Postacute rehabilitation quality of care: toward a shared conceptual framework. Arch Phys Med Rehabil. 2015 May;96(5):960–9.
Jesus, Tiago Silva, and Helen Hoenig. “Postacute rehabilitation quality of care: toward a shared conceptual framework.Arch Phys Med Rehabil, vol. 96, no. 5, May 2015, pp. 960–69. Pubmed, doi:10.1016/j.apmr.2014.12.007.
Jesus TS, Hoenig H. Postacute rehabilitation quality of care: toward a shared conceptual framework. Arch Phys Med Rehabil. 2015 May;96(5):960–969.
Journal cover image

Published In

Arch Phys Med Rehabil

DOI

EISSN

1532-821X

Publication Date

May 2015

Volume

96

Issue

5

Start / End Page

960 / 969

Location

United States

Related Subject Headings

  • Rehabilitation
  • Recovery of Function
  • Quality of Life
  • Quality of Health Care
  • Physical Therapy Modalities
  • Patient-Centered Care
  • Patient Satisfaction
  • Patient Discharge
  • Outcome and Process Assessment, Health Care
  • Humans