Towards the implementation of clinical quality management at the national level: description of current types of rehabilitation services for spinal cord injury/disorder in Switzerland using an interdisciplinary consensus process.

BACKGROUND

Aligned with WHO's Global Disability Action Plan 2014-2021, the Section and Board of the European Union of Medical Specialists (UEMS-PRM) set up a plan to strengthen rehabilitation and support International Classification for Functioning, Disability and Health-based clinical quality management. Accordingly, the UEMS-PRM developed the European Framework of Rehabilitation Service Types ("European Framework"). The specifications of these service types may differ across countries and for specific application areas.

AIM: The objective of this paper is to report on the development of a framework of rehabilitation service types for spinal cord injury/disorder (SCI/D) in Switzerland ("SCI/D Framework").

DESIGN

Quality improvement in healthcare.

SETTING

The setting of this study was in Switzerland.

POPULATION: Representatives of medical societies.

METHODS

A multistage consensus process was conducted and involved representatives of national medical and rehabilitation societies recruited based on a situational analysis of existing national quality management documents. The process comprised the development of an initial framework based on the European Framework, a survey, a face-to-face consensus meeting, and a confirmatory feedback round on the version of the SCI/D Framework resulting from the meeting.

RESULTS

Representatives of 12 national medical societies, one political body in rehabilitation, one national interprofessional rehabilitation society, the Swiss representative of two international rehabilitation societies and heads of four SCI/D specialized centers participated in the multistage consensus process. After the modifications based on the results of the survey, the consensus meeting and confirmatory feedback round were made, the resulting SCI/D Framework version encompassed 19 rehabilitation service types, structured in nine different clusters, of which six were subdivided into general, other specific or SCI/D-specific rehabilitation service types.

CONCLUSIONS

Developing the SCI/D Framework for Switzerland was a further step toward refining existing quality criteria and national quality standards for rehabilitation and toward scaling up SCI/D rehabilitation in Switzerland.

CLINICAL REHABILITATION IMPACT: The SCI/D Framework can support national efforts to address any gaps in health care provision and guide an optimal response to meet the rehabilitation needs of persons with SCI/D in Switzerland. Furthermore, the development of the SCI/D Framework illustrates an outline that can be used to develop a similar framework for other health conditions and for other countries to follow in adapting the European Framework for their own country context.