Qualitätssicherung und Qualitätsmanagement in der medizinischen Rehabilitation

Abstract

External quality assurance in medical rehabilitation is characterized by the programs of Germany's two largest providers of rehabilitation (the German pension insurance and the statutory health insurance). The programs were developed with considerable input from scientific institutes. Their strengths lie in measuring several relevant dimensions of quality, the comprehensive implementation for nearly all illnesses treated, integration of the patient perspective, and realization of prospective study designs with follow-up. Weaknesses include low relevance for patient allocation and compensation, the absence of systematic evaluations, and a lack of published patient information on the results of the quality measurements. Internal quality management in medical rehabilitation is regulated by sweeping legal guidelines. Since 2009, a statutory agreement has been in effect which includes a provision that all inpatient rehabilitation centers must be certified by October 2012. Areas for potential improvements in internal quality management processes include an improved theoretical basis, higher specificity for rehabilitation, and a more transparent, methodically improved structure of certification procedures.

Development and psychometric properties of a scale for measuring internal participation from a patient and health care professional perspective

“…For defining convergent validity, the standardised Questionnaire on staff satisfaction in medical rehabilitation was used [33,34]. It consists of three scales: workplace atmosphere/climate (7 items), leadership (14 items) as well as organization and communication (10 items).…”

Influence of quality of care and individual patient characteristics on quality of life and return to work in survivors of the acute respiratory distress syndrome: protocol for a prospective, observational, multi-centre patient cohort study (DACAPO)

“…As to date there are no agreed quality indicators for the treatment of patients suffering from ARDS, the selection of all quality indicators was informed by more generic recommendations regarding QoC of critically ill patients. We refer to the German quality indicators in intensive care medicine [ 18 ], the recommendations for inter-hospital transport by the German Interdisciplinary Society of Intensive Care Medicine ( Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin , DIVI) [ 19 ] and the recommendations regarding structural quality of rehabilitation centres made by the German Statutory Pension Insurance and the German Statutory Health Insurance [ 20 ].…”

Qualitätsmanagement und Qualitätssicherung im Gesundheitswesen – Theorie und Status Quo gesetzlicher Regelungen in Deutschland

“…Daten zu Struktur-, Prozess-und Ergebnisqualität (Prozessorientierung) werden mit Fragebögen erhoben. Damit findet eine umfassende Leistungsmessung mehrerer relevanter Qualitätsdimensionen statt (Ganzheitlichkeit) [44]. Für die Grundsätze Mitarbeiterorientierung und Führung finden sich in den gesetzlichen Vorgaben und Richtlinien jedoch keine Ansätze.…”