Article

OBJECTIVES: To develop evidence-based and expert-driven quality indicators for
measuring variations in the structure and organization of acute inpatient
rehabilitation for children after traumatic brain injury (TBI) and to survey
centers across the United States to determine the degree of variation in care.
DESIGN: Quality indicators were developed using the RAND/UCLA modified Delphi
method. Adherence to these indicators was determined from a survey of
rehabilitation facilities. SETTING: Inpatient rehabilitation units in the United States. PARTICIPANTS:
A sample of rehabilitation programs identified using data
from the National Association of Children's Hospitals and Related Institutions,
Uniform Data System for Medical Rehabilitation, and the Commission on
Accreditation of Rehabilitation Facilities yielded 74 inpatient units treating
children with TBI. Survey respondents comprised 31 pediatric and 28 all age
units. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Variations in
structure and organization of care among institutions providing acute inpatient
rehabilitation for children with TBI. RESULTS: Twelve indicators were developed.
Pediatric inpatient rehabilitation units and units with higher volumes of
children with TBI were more likely to have: a census of at least 1 child admitted
with a TBI for at least 90% of the time ; adequate specialized equipment; a
classroom; a pediatric subspecialty trained medical director; and more than 75%
of therapists with pediatric training. CONCLUSIONS: There were clinically and
statistically significant variations in the structure and organization of acute
pediatric rehabilitation based on the pediatric focus of the unit and volume of children with TBI.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS