Quality and Outcome Measures for Medical Rehabilitation

Optimal healthcare quality can be defined as the provision of safe and effective care that improves outcomes, optimizes health, results in higher patient satisfaction, and furthers quality of life. The focus of healthcare worldwide has shifted from the fee-for-services model in which healthcare services rendered were rewarded in terms of volume to an emphasis on the best possible quality, safety, and outcomes as the top priorities. Thus the evaluation, measurement, and reporting of quality and outcomes have become the business of not only every healthcare institution and hospital but also of every individual healthcare provider. Physical medicine and rehabilitation practitioners have become increasingly aware of the importance of measuring healthcare quality and outcomes. This comes from increased scrutiny of healthcare quality, the cost of care, and quality reporting requirements from third-party payers, insurance companies, and reimbursing agencies. However, practicing physiatrists and professional member societies have also been realizing the importance of data on healthcare quality and outcomes. This has driven advancements in and availability of data repositories such as clinical registries. This chapter discusses healthcare quality, evidence-based medicine, clinical practice guidelines, outcome measures, performance measures, practice improvement, patient safety, and accreditation as it applies to healthcare in general and the practice of physical medicine and rehabilitation in particular.