Quality assurance in rehabilitation: where do we stand today?

Abstract

In the sector of medical rehabilitation in Germany, a quality assurance programme has been established over the last decade. What distinguishes this programme in comparison to other sectors of the health care system is its comprehensive approach (including quality of structures, processes and outcomes), the special attention given to patients' needs, its scientific foundation, and its implementation throughout the sector. Participation in this programme is obligatory for all in-patient rehabilitation facilities. For out-patient rehabilitation, a specific programme is currently being developed. The feedback report to the facilities gives them concrete indications of existing strengths and weaknesses and thus offers them a start for developing their quality by means of internal quality management. The article begins with a presentation of the instruments and procedures applied as well as selected results of the previous surveys in the context of external quality assurance. Subsequently, the most important approaches to internal quality management are explained. The article ends with a description of the strengths and weaknesses of the existing quality assurance programmes and proposes steps to be taken for their further development.