TY - JOUR
T1 - Variation in adherence to new quality-of-care indicators for the acute rehabilitation of children with traumatic brain injury
AU - Rivara, Frederick P.
AU - Ennis, Stephanie K.
AU - Mangione-Smith, Rita
AU - MacKenzie, Ellen J.
AU - Jaffe, Kenneth M.
N1 - Funding Information:
Supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant no. R21 HD059049-01A1 ).
PY - 2012/8
Y1 - 2012/8
N2 - Objective: To determine variations in care provided by 9 inpatient rehabilitation units for children with traumatic brain injury (TBI) using newly developed quality indicators. Design: Retrospective cohort study. Setting: Nine inpatient rehabilitation units. Participants: Children (N=174; age range, 0-17y) admitted for the inpatient rehabilitation of moderate to severe TBI. Interventions: Not applicable. Main Outcome Measures: Adherence to 119 newly developed quality-of-care indicators in 7 different domains: general care, family-centered care, cognitive-communication, motor, neuropsychological, school, and community integration. Results: There was substantial variation both within and between institutions in the percentage of patients receiving recommended care in the 7 domains. The lowest scores were found for the school domain. Only 5 institutions scored above 50% for all quality indicators, and only 1 institution scored above 70% overall. Greater adherence to quality indicators was found for facilities with a higher proportion of therapists with pediatric training and for facilities that only admitted children. Patient volume was not associated with adherence to quality indicators. Conclusions: The results indicate a tremendous variability and opportunity for improvement in the care of children with TBI.
AB - Objective: To determine variations in care provided by 9 inpatient rehabilitation units for children with traumatic brain injury (TBI) using newly developed quality indicators. Design: Retrospective cohort study. Setting: Nine inpatient rehabilitation units. Participants: Children (N=174; age range, 0-17y) admitted for the inpatient rehabilitation of moderate to severe TBI. Interventions: Not applicable. Main Outcome Measures: Adherence to 119 newly developed quality-of-care indicators in 7 different domains: general care, family-centered care, cognitive-communication, motor, neuropsychological, school, and community integration. Results: There was substantial variation both within and between institutions in the percentage of patients receiving recommended care in the 7 domains. The lowest scores were found for the school domain. Only 5 institutions scored above 50% for all quality indicators, and only 1 institution scored above 70% overall. Greater adherence to quality indicators was found for facilities with a higher proportion of therapists with pediatric training and for facilities that only admitted children. Patient volume was not associated with adherence to quality indicators. Conclusions: The results indicate a tremendous variability and opportunity for improvement in the care of children with TBI.
KW - Adolescent
KW - Child
KW - Quality of health care
KW - Rehabilitation
KW - Traumatic brain injuries
UR - http://www.scopus.com/inward/record.url?scp=84864353787&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84864353787&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2012.02.031
DO - 10.1016/j.apmr.2012.02.031
M3 - Article
C2 - 22446294
AN - SCOPUS:84864353787
SN - 0003-9993
VL - 93
SP - 1371
EP - 1376
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 8
ER -