Rehabilitation Outcomes and Assessment: Toward a Model of Complex Adaptive Rehabilitation

Abstract

Vigorous international debate continues regarding standards of evidence in rehabilitation and guidelines for evidence reviews, as these impact reimbursement and drive scientific and clinical practices. A large portion of rehabilitation research funding in the United States goes toward the development of standardized rating scales and taxonomies of treatments. Another trend—quality improvement—is increasingly evident in the study of services in medicine, nursing, and psychotherapy, and is just beginning to enter the rehabilitation literature. Among many contributions, international communities collaborating in quality improvement have promoted greater awareness of the challenges and opportunities posed by complex adaptive systems. In this chapter, after reviewing dominant trends, we describe how methods of research from the quality improvement tradition and other methods compatible with it may transform processes and outcomes in rehabilitation.

Peculiarities of Institutional Stage of Inpatient Rehabilitation After Cardio-Surgical Interventions

“…За останні роки удосконалення методів діагностики, технічного оснащення та підвищення компетентності лікарів дало можливість для раннього попередження тяжких перебігів ССЗ. Це зумовило необхідність активного впровадження у сучасну медичну практику не лише методів первинної та вторинної профілактики, а і методів кардіохірургічного лікування [3]. На сьогоднішній день в Україні функціонує 24 кардіохірургічних центра, в яких виконують близько 20 тисяч операцій на рік.…”

Rehabilitation psychologists in critical care settings.

“…However, in some settings with increased exposure to rehabilitation psychology services, the critical and intensive care teams also not only request but expect intervention-oriented services (e.g., behavioral management, family education and support, nonpharmacologic pain management, psychotherapy). Also, due to shortened length of stay and increased barriers to inpatient rehabilitation admission, the team also often recognizes that if these services are not requested early, they might never be received (Nancy Merbitz, personal communication, November 23, 2016;Merbitz, Merbitz, & Ripsch, 2012).…”