We found the recent articles
1
,
2
and commentary
3
on quality of care measures in pediatric traumatic brain injury (TBI) to be informative,
thought-provoking, and yet somewhat disheartening. The work of the National Expert
Panel for the Development of Pediatric Quality of Care Indicators strives to advance
quality in pediatric TBI with designation of quality indicators and the demonstration
of meaningful variations of adherence in a subset of indicators across rehabilitation
units. The work offers a foundation to study quality in this population, and from
such a platform, design and implement worthwhile quality improvement (QI) initiatives.
Still, among all these data, something fundamental seems to be missing: rehabilitation
is a team endeavor and interdisciplinary team care is a defining characteristic of
the field and how we do our work.- Whyte J.
Invited commentary on quality of care indicators for the rehabilitation of children
with traumatic brain injury, and quality of care indicators for the structure and
organization of inpatient rehabilitation care of children with traumatic brain injury.
Arch Phys Med Rehabil. 2012; 93: 394-395
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References
- Quality of care indicators for the rehabilitation of children with traumatic brain injury.Arch Phys Med Rehabil. 2012; 93: 381-385
- Quality of care indicators for the structure and organization of inpatient rehabilitation care of children with traumatic brain injury.Arch Phys Med Rehabil. 2012; 93: 386-393
- Invited commentary on quality of care indicators for the rehabilitation of children with traumatic brain injury, and quality of care indicators for the structure and organization of inpatient rehabilitation care of children with traumatic brain injury.Arch Phys Med Rehabil. 2012; 93: 394-395
- Improving safety on the front line: the role of clinical microsystems.Qual Saf Health Care. 2002; 11: 45-50
- Improving and sustaining core measure performance through effective accountability of clinical microsystems in an academic medical center.Jt Comm J Qual Patient Saf. 2010; 36: 387-398
- Rehabilitation team process.Top Stroke Rehabil. 1997; 4: 34-39
- Team functioning and patient outcomes in stroke rehabilitation.Arch Phys Med Rehabil. 2005; 86: 403-409
- Team training and stroke rehabilitation outcomes: a cluster randomized trial.Arch Phys Med Rehabil. 2008; 89: 10-15
- Rehabilitation team process: measuring team process for quality improvement.Top Stroke Rehabil. 1977; 4: 34-39
Article info
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Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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- Quality of Care Indicators for the Structure and Organization of Inpatient Rehabilitation Care of Children With Traumatic Brain InjuryArchives of Physical Medicine and RehabilitationVol. 93Issue 3
- PreviewZumsteg JM, Ennis SK, Jaffe KM, Mangione-Smith R, MacKenzie EJ, Rivara FP, and the National Expert Panel for the Development of Pediatric Rehabilitation Quality of Care Indicators. Quality of care indicators for the structure and organization of inpatient rehabilitation care of children with traumatic brain injury.
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- Invited Commentary on Quality of Care Indicators for the Rehabilitation of Children With Traumatic Brain Injury, and Quality of Care Indicators for the Structure and Organization of Inpatient Rehabilitation Care of Children With Traumatic Brain InjuryArchives of Physical Medicine and RehabilitationVol. 93Issue 3
- PreviewWhyte J. Invited commentary on quality of care indicators for the rehabilitation of children with traumatic brain injury, and quality of care indicators for the structure and organization of inpatient rehabilitation care of children with traumatic brain injury. Measures of structure and process in health care have been shown to be associated with care outcomes in prior research. Two articles in this issue propose measures of structure and process that may be relevant to pediatric traumatic brain injury rehabilitation.
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- Quality of Care Indicators for the Rehabilitation of Children With Traumatic Brain InjuryArchives of Physical Medicine and RehabilitationVol. 93Issue 3
- The Author RespondsArchives of Physical Medicine and RehabilitationVol. 93Issue 11
- PreviewI appreciate the comments of Strasser and colleagues in response to the articles on pediatric rehabilitation quality indicators,1,2 and my commentary3 on them. As they note, we are in agreement on many points, but they suggest a need to focus more intensively on rehabilitation team functioning as another quality indicator. As noted in my commentary, I view structural and process measures as indicators of the types of environments and procedures that are likely to promote delivery of optimally therapeutic experiences.
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- The Authors RespondArchives of Physical Medicine and RehabilitationVol. 93Issue 11
- PreviewWe thank Drs. Strasser, Falconer, and Uomoto for their letter regarding our articles,1,2 and value the conversation regarding quality of care indicators for rehabilitation care. We agree that the methods to implement care, which meet these quality standards, are all important. All medical care is delivered by teams, and the way teams function can dramatically affect the quality of care seen by patients and their families. The indicators developed by the National Expert Panel for the Development of Pediatric Rehabilitation Quality Care Indicators serve as a starting point to assess whether the team of providers for the inpatient rehabilitation of children with traumatic brain injuries is following evidence-based practices.
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