Establishing Standards for the Provision of Brain Injury Services

Moseley, Anne M.; Rotem, Wendy

doi:10.3109/02699059509005775

Cited by 6 publications

(4 citation statements)

References 2 publications

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“…Some reasons that could be hypothesized for the positive attributions include the perceived independence and expertize of the interpreter, allaying concerns about what bilingual family members might`censor' in interpreting information and/or their capacity to interpret technical medical information reliably. In addition, respondents/family members may well have attributed the same`expertize and authority' to the interpreters as to the other rehabilitation team members, as the BIRU is part of the state health sector [31] and accesses state health department interpreters trained in health issues and who have to meet national accreditation standards [30]. Whilst the problems caused by using family members as interpreters have been identified by professionals [14,15], there are few accounts in the literature of family members identifying the same issues.…”

Section: Discussionmentioning

confidence: 99%

Cultural variations in the understanding of traumatic brain injury and brain injury rehabilitation

Simpson

R²,

Redman³

2000

Brain Injury

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Little is known about how people from different cultures experience and understand traumatic brain injury (TBI) and the process of brain injury rehabilitation. The Brain Injury Rehabilitation Unit (BIRU) undertook a qualitative project to research cultural variations in the understanding of TBI and the rehabilitation process, interviewing 39 people with TBI and family members from Italian, Lebanese and Vietnamese backgrounds. The focus was on the reporting of sequelae of the TBI; valued qualities of service providers; barriers to effective communication; the role of the families in the rehabilitation process; and the experience of social stigma. Findings suggest there is a universal experience of TBI that transcends individual cultures. Study participants valued attentiveness, friendliness and guidance from rehabilitation staff. Family support was not always available to the person with TBI due to family conflict. Generally, people with TBI and family members valued the assistance of health interpreters facilitating their communication with rehabilitation staff. People with TBI from all three cultures experienced problems of stigma and social isolation. The findings have a number of implications for how brain injury rehabilitation staff can approach service provision to people from diverse cultural backgrounds.

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Section: Discussionmentioning

confidence: 99%

Cultural variations in the understanding of traumatic brain injury and brain injury rehabilitation

Simpson

R²,

Redman³

2000

Brain Injury

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“…Beide Ansätze können auch kombiniert werden, wie z. B. in einem kanadischen Peer-Assessment-Programm für Allgemeinärzte [6] und im australischen Brain Injury Rehabilitation Program [1]. Peer Reviews gehören zu den am häufigsten eingesetzten Qualitätssicherungsverfahren in der Medizin und haben im akutmedizinischen Bereich wesentlich zum Wissen über medizinische Fehler und vermeidbare Behandlungskomplikationen beigetragen [7].…”

Section: Introductionunclassified

“…Der vorliegende Beitrag stellt die Ergebnisse der Erhebungsrunde 2000/2001 im Peer-Review der Rentenversicherung in den somatischen Indikationsbereichen sowie Resultate methodischer Prüfungen zur Reliabilität des Verfahrens dar 1 . Berichtet wird zunächst (dritter Abschnitt) von der Interrater-Reliabilität der Bewertung durch einen einzelnen Peer.…”

Section: Introductionunclassified

Die Bewertung des Rehabilitationsprozesses mittels des Peer-Review-Verfahrens: Methodische Prüfung und Ergebnisse der Erhebungsrunde 2000/2001 in den somatischen Indikationsbereichen

Farin

Carl²,

Lichtenberg³

et al. 2003

Rehabilitation

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This paper reports the results of a peer review system that was implemented in the context of the quality assurance programme of the statutory German Pension Insurance scheme. The data reported refer to the 2000/2001 data collection period for medical rehabilitation in the somatic indications. Examination of inter-rater reliability for judgements of individual raters shows satisfactory results only in orthopaedics. In the quality assurance programme, rehabilitation centres are usually evaluated by the mean of 20 rater judgements. The reliability of this aggregated measure is satisfactory in all indications. The results of 561 rehabilitation centres show that those quality criteria are in particular need of improvement that refer to subjective concepts of patients (e. g., subjective theories of illness). Between peer review procedures in 1998 and 1999, the quality scores of rehabilitation centres had improved whereas between 1999 and 2000/2001, no further improvement can be shown. However, those rehabilitation centres with a low quality score in 1999 (lowest quartile of the distribution) underwent a positive development between 1999 and 2000/2001. Reasons for this trend and possibilities for improving interrater reliability of the peer review process as an element of the quality assurance programme of the German Pension Insurance scheme are discussed.

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“…The Commission on Accreditation of Rehabilitation Facilities (CARF) increasingly focuses on outcome-orientated standards, rather than on the quality of process alone. 7 In Australia, the Australian Council of Healthcare Standards has set standards for brain injury rehabilitation services, 8 and in Europe, a task-force of the European Federation of Neurological Societies (EFNS) has developed minimum standards for neurological rehabilitation. 9 Within the UK, the development of monitored systems for Lynne Turner-Stokes 136…”

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confidence: 99%

The development of clinical governance in the UK: its implications for rehabilitation medicine

Turner-Stokes

2003

Clinical Medicine

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-Clinical governance has been introduced in the UK as a mechanism to improve the quality of health services, and the professional performance of clinicians. Specialist societies have a pivotal role to play in developing systems to support its implementation in clinical practice. Rehabilitation medicine is a specialty characterised by closely integrated interdisciplinary teamwork. The particular issues that this poses for clinical governance may also be relevant to other specialities. This paper presents an overview of the development of audit and clinical governance procedures in the UK and their specific implications for rehabilitation medicine. It also summarises the work undertaken to date by the British Society for Rehabilitation Medicine towards implementation of clinical governance, to improve the quality of care offered to patients. KEY WORDS: clinical audit, clinical governance, clinical standards, rehabilitation medicine Clinical governance in the UKThroughout the 1990s, clinical audit was the hallmark of quality assurance in the UK. Essential features of clinical audit were the systematic assessment of clinical practice, against agreed standards, to ensure the best quality of care. Implementation of change was then followed by re-audit to complete the audit cycle.However, audit had no real teeth. There was no statutory duty applicable to NHS hospital trusts with respect to quality of care. In a competitive openmarket health system, the only statutory requirement for hospital managers was to maintain financial balance. In 1998, the UK Government introduced reforms for 'modernisation' . 1 Clinical governance was the framework through which NHS organisations would be 'accountable for continuously improving the quality of their services' . The audit cycle became the audit spiral (Fig 1), 2 and hospital trust boards now had statutory responsibility for the quality of services, as well as financial management. 3 Nationally agreed standards and guidelinesA central tenet of clinical governance is the elimination of unnecessary variation in practice. 'Benchmarking' is now required against nationally agreed standards which are based on research evidence or consensus of widely gathered expert opinion.The terms 'standards' and 'guidelines' are sometimes used interchangeably, but this is incorrect.Standards define the quality of service delivery, while guidelines provide guidance to the clinician for individual patient care. A 'standard' is therefore interpreted at the level of a population, while a 'guideline' is interpreted at the level of the individual. Nevertheless there is a close relationship between the two, illustrated in Box 1. 4 If guidelines are to become 'compulsory' practice, the advice must be correct and up to date. Guideline developers carry a major responsibility and the process must be meticulous. In the UK, the Scottish Intercollegiate Guidelines Network (SIGN) pioneered guideline development with a rigorous system of gathering and evaluating evidence, achieving consensus through consu...

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Establishing Standards for the Provision of Brain Injury Services

Cited by 6 publications

References 2 publications

Cultural variations in the understanding of traumatic brain injury and brain injury rehabilitation

Cultural variations in the understanding of traumatic brain injury and brain injury rehabilitation

Die Bewertung des Rehabilitationsprozesses mittels des Peer-Review-Verfahrens: Methodische Prüfung und Ergebnisse der Erhebungsrunde 2000/2001 in den somatischen Indikationsbereichen

The development of clinical governance in the UK: its implications for rehabilitation medicine

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