Quality assurance in a rehabilitation service

Abstract

Aim: The aim of this study was to develop, implement and evaluate a Quality Assurance (QA) programme for use by nine rehabilitation departments in the Midlands province of Zimbabwe. Methodology: A participatory methodology was implemented to: 1. Define and implement the parameters of quality for a rehabilitation service. 2. Design standardised assessment forms for the different conditions managed. 3. Develop, pilot and evaluate a QA measuring instrument to use in defining the QA profile of a rehabilitation service, and 4. Determine patient satisfaction with the rehabilitation service. Administering a simple questionnaire, whose design was based on the Zimbabwe Patients Charter, accomplished this. Results: The process of developing, implementing and evaluation of the QA programme took six years. One year after implementation of the QA, all (J00%) patients coming into contact with the service had a rehabilitation record. The QA profile for the Midlands province rose from 55% in 1994 to a record high of 92.1% in 1998, and 89.4% in 1999. The patient satisfaction profile for each indicator also demonstrated a linear increase with areas such as satisfaction with service rising from 86% in 1997 to 100% in 2000, and satisfaction with benefit from the service rising from 76.6% in 1997 to 100% in 2000. Other qualitative benefits not depicted by the QA measuring instrument or the patient satisfaction instrument, but which were observed and expressed by rehabilitation staff as measures of success of the QA programme are discussed. Conclusion: This paper concludes that significant improvements in clinical documentation arising from the QA programme, translated to an overall increase in the service providers’ professional skills and knowledge base, and ultimately rehabilitation outcomes. The success of this process is attributed to its participatory and empowering nature.

Keywords

• quality assurance
• rehabilitation service