Strukturen und Prozesse in der ambulanten Neurorehabilitation

Objective: Quality of structures, processes and outcome are commonly accepted as dimensions of quality management and quality assurance. Data of structures and processes are not published to date for German outpatient neurorehabilitation. Rehabilitative care and service providers are legally bound to apply concepts of quality management and quality assurance. The service providers pass recommendations, which have to be implemented by outpatient neurorehabilitation centres. Data analysis of existing structures and processes in outpatient neurorehabilitation centres are embedded as a part of a long-term multicentres outcome study. Method: 22 outpatient neurorehabilitation centres participated in an online survey with 227 items using the google tool Docs between September and December 2011. Following issues were asked: general information about the centres (e.g. date of establishment, number of therapy places, kind of patients, responsible organization), utility supply contracts with service providers, local cooperation and networking, staff and equipment and appliances, treatment concepts, processes of therapy (e.g. individual and group therapy, frequency, concentration, planning), team processes, goals and team development, quality management and documentation. Results and conclusions: In the meantime outpatient centres of neurorehabilitation are well-established as care providers and commonly accepted by service providers. However a comprehensive availability does not exist. The results show comparable structures of the centres, what is mostly determined by the service provider audited regulatory framework. Different concepts result in different processes. There are a lot of hints with respect to different concepts in form and content to implement the legally obligated mandate. In general their work with context factors is still a frequently unused potential. It can be countered by the therapeutic inclusion of the social and environmental living conditions of the patients.