May 15, 2013
Healthcare quality in the United States varies widely; this variation has created calls for performance improvement and provider accountability to improve care quality. The only way to know if healthcare quality is improving is to document performance using standard quality measures. Quality measures permit comparisons of how well hospitals deliver care. Quality measures are used for public reporting, quality improvement, and hospital payments.
Patient-reported outcome measures (PROMs) provide a valuable information source in describing health changes during rehabilitation hospitalization. However, inpatient rehabilitation facilities rely primarily on clinician-rated outcomes, such as functional status and goal attainment; the patient’s voice is not a part of hospital evaluations. However, there are major challenges to using PROMs for accountability and performance improvement, including limited use in clinical practice and uncertainty about how to aggregate PROMs for performance improvement.
This proposal addresses this lack of information by identifying issues that are important to the quality of care for rehabilitation patients that could be collected as patient-reported outcomes. We will evaluate the feasibility of collecting PROMs and specify the questions that are required for quality measure development.
An advisory committee of stakeholders will help guide the project; it consists of consumer advocacy organizations, patients, clinicians, and policy makers. They will provide input on valued outcomes of medical rehabilitation and patient-reported outcomes that reflect these values. The project’s design includes focus groups of patients with stroke, spinal cord injury, traumatic brain injury, Parkinson’s disease, multiple sclerosis, and other neurological disorders. We will administer advisory committee–selected PROMs to 300 rehabilitation inpatients and evaluate the feasibility of PROM administration, considering patient and organizational issues.
Funder: The Canadian Patient Safety Institute
Allen Heinemann, PhD