ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2022 April;58(2):190-8

DOI: 10.23736/S1973-9087.21.06923-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Towards the implementation of clinical quality management at the national level: description of current types of rehabilitation services for spinal cord injury/disorder in Switzerland using an interdisciplinary consensus process

Anke SCHEEL-SAILER ^{1, 2} ✉, Melissa SELB ^{3, 4}, Hans P. GMÜNDER ¹, Michael BAUMBERGER ¹, Armin CURT ⁵, Margret HUND-GEORGIADIS ⁶, Xavier JORDAN ⁷, Gerold STUCKI ^{2, 3, 4}, the Swiss SCI/D Rehabilitation Interest Group 

¹ Swiss Paraplegic Center, Nottwil, Switzerland; ² Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; ³ Swiss Paraplegic Research, Nottwil, Switzerland; ⁴ ICF Research Branch, Nottwil, Switzerland; ⁵ Universitätsklinik Balgrist, Zentrum für Paraplegie, Zurich, Switzerland; ⁶ Rehab of Basel, Basel, Switzerland; ⁷ Clinique Romande de Réadaptation, Sion, Switzerland

BACKGROUND: Aligned with WHO’s Global Disability Action Plan 2014-2021, the Section and Board of the European Union of Medical Specialists (UEMS-PRM) set up a plan to strengthen rehabilitation and support International Classification for Functioning, Disability and Health-based clinical quality management. Accordingly, the UEMS-PRM developed the European Framework of Rehabilitation Service Types (“European Framework”). The specifications of these service types may differ across countries and for specific application areas.
AIM: The objective of this paper is to report on the development of a framework of rehabilitation service types for spinal cord injury/disorder (SCI/D) in Switzerland (“SCI/D Framework”).
DESIGN: Quality improvement in healthcare.
SETTING: The setting of this study was in Switzerland.
POPULATION: Representatives of medical societies.
METHODS: A multistage consensus process was conducted and involved representatives of national medical and rehabilitation societies recruited based on a situational analysis of existing national quality management documents. The process comprised the development of an initial framework based on the European Framework, a survey, a face-to-face consensus meeting, and a confirmatory feedback round on the version of the SCI/D Framework resulting from the meeting.
RESULTS: Representatives of 12 national medical societies, one political body in rehabilitation, one national interprofessional rehabilitation society, the Swiss representative of two international rehabilitation societies and heads of four SCI/D specialized centers participated in the multistage consensus process. After the modifications based on the results of the survey, the consensus meeting and confirmatory feedback round were made, the resulting SCI/D Framework version encompassed 19 rehabilitation service types, structured in nine different clusters, of which six were subdivided into general, other specific or SCI/D-specific rehabilitation service types.
CONCLUSIONS: Developing the SCI/D Framework for Switzerland was a further step toward refining existing quality criteria and national quality standards for rehabilitation and toward scaling up SCI/D rehabilitation in Switzerland.
CLINICAL REHABILITATION IMPACT: The SCI/D Framework can support national efforts to address any gaps in health care provision and guide an optimal response to meet the rehabilitation needs of persons with SCI/D in Switzerland. Furthermore, the development of the SCI/D Framework illustrates an outline that can be used to develop a similar framework for other health conditions and for other countries to follow in adapting the European Framework for their own country context.

KEY WORDS: Rehabilitation; Spinal cord injuries; Evidence-based practice; Health services