The assistive technology (AT) community has been challenged to effectively measure the outcomes of AT services. There has been much discussion recently in the literature about how to conceptualize and respond to this challenge. In this paper, we suggest that these objectives are best accomplished when AT services are understood within the contexts of the total rehabilitation of AT users and the institutional culture in which services are delivered. We provide examples of outcome priorities we have identified and the tools and approaches we have used. These include projects in the areas of clinical, functional, and psychosocial outcomes assessment of ATs.
While the Excellent Care for All Act, 2010 (ECFA Act) provides a comprehensive approach to stimulating quality improvement in healthcare, there are other examples of legislations articulating strategies aimed at the same goal but proposing different approaches. This paper reviews quality of care legislations in the Netherlands, the United States, England and Australia, compares those pieces of legislation with the ECFA Act and suggests lessons for Ontario in planning the next stages of its healthcare quality strategy. Notable among the commonalities that the EFCA Act shares with the selected examples of legislation are mandatory reporting of performance results at an organizational level and furthering quality improvement, evidence generation and performance monitoring. However, the EFCA Act does not include any elements of restructuring or competition, unlike some of the other examples. Key to successful transformation of the Ontario healthcare system will be to propose a package of changes that will deal systematically with all aspects of transformation sought (including structural changes, payments systems and elements of competition), will garner support from all the actors, and will be implemented consistently and persistently. Benchmarking on the implementation and impact of reforms with the countries presented in this paper may be an additional important step.
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