The Experts below are selected from a list of 94284 Experts worldwide ranked by ideXlab platform
Frederick P Rivara - One of the best experts on this subject based on the ideXlab platform.
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Rehabilitation following pediatric traumatic brain injury variability in adherence to psychosocial quality of Care indicators
Journal of Head Trauma Rehabilitation, 2014Co-Authors: Stephanie K Ennis, Kenneth M Jaffe, Rita Mangionesmith, Ellen J Mackenzie, Mark A Konodi, Frederick P RivaraAbstract:Objective To examine variations in processes of pediatric inpatient Rehabilitation Care related to family-centered Care, management of neurobehavioral and psychosocial needs, and community reintegration after traumatic brain injury. Setting Nine acute Rehabilitation facilities from geographically diverse areas of the United States. Participants A total of 174 children with traumatic brain injury. Design Retrospective chart review. Main measures Adherence to Care indicators (the number of times recommended Care was delivered or attempted divided by the number of times Care was indicated). Results Across facilities, adherence rates (adjusted for difficulty of delivery) ranged from 33.6% to 73.1% (95% confidence interval, 13.4-53.9, 58.7-87.4) for family-centered processes, 21.3% to 82.5% (95% confidence interval, 6.6-36.1, 67.6-97.4) for neurobehavioral and psychosocial processes, and 22.7% to 80.3% (95% confidence interval, 5.3-40.1, 68.1-92.5) for community integration processes. Within facilities, standard deviations for adherence rates were large (24.3-34.9, family-centered domain; 22.6-34.2, neurobehavioral and psychosocial domain; and 21.6-40.5, community reintegration domain). Conclusion The current state of acute Rehabilitation Care for children with traumatic brain injury is variable across different quality-of-Care indicators addressing neurobehavioral and psychosocial needs and facilitating community reintegration of the patient and the family. Individual Rehabilitation facilities demonstrate inconsistent adherence to different indicators and inconsistent performance across different Care domains.
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quality of Care indicators for the structure and organization of inpatient Rehabilitation Care of children with traumatic brain injury
Archives of Physical Medicine and Rehabilitation, 2012Co-Authors: Jennifer M Zumsteg, Stephanie K Ennis, Kenneth M Jaffe, Rita Mangionesmith, Ellen J Mackenzie, Frederick P RivaraAbstract:Abstract Zumsteg JM, Ennis SK, Jaffe KM, Mangione-Smith R, MacKenzie EJ, Rivara FP, and the National Expert Panel for the Development of Pediatric Rehabilitation Quality of Care Indicators. Quality of Care indicators for the structure and organization of inpatient Rehabilitation Care of children with traumatic brain injury. Objectives To develop evidence-based and expert-driven quality indicators for measuring variations in the structure and organization of acute inpatient Rehabilitation for children after traumatic brain injury (TBI) and to survey centers across the United States to determine the degree of variation in Care. Design Quality indicators were developed using the RAND/UCLA modified Delphi method. Adherence to these indicators was determined from a survey of Rehabilitation facilities. Setting Inpatient Rehabilitation units in the United States. Participants A sample of Rehabilitation programs identified using data from the National Association of Children's Hospitals and Related Institutions, Uniform Data System for Medical Rehabilitation, and the Commission on Accreditation of Rehabilitation Facilities yielded 74 inpatient units treating children with TBI. Survey respondents comprised 31 pediatric and 28 all age units. Interventions Not applicable. Main Outcome Measures Variations in structure and organization of Care among institutions providing acute inpatient Rehabilitation for children with TBI. Results Twelve indicators were developed. Pediatric inpatient Rehabilitation units and units with higher volumes of children with TBI were more likely to have: a census of at least 1 child admitted with a TBI for at least 90% of the time; adequate specialized equipment; a classroom; a pediatric subspecialty trained medical director; and more than 75% of therapists with pediatric training. Conclusions There were clinically and statistically significant variations in the structure and organization of acute pediatric Rehabilitation based on the pediatric focus of the unit and volume of children with TBI.
Rita Mangionesmith - One of the best experts on this subject based on the ideXlab platform.
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Rehabilitation following pediatric traumatic brain injury variability in adherence to psychosocial quality of Care indicators
Journal of Head Trauma Rehabilitation, 2014Co-Authors: Stephanie K Ennis, Kenneth M Jaffe, Rita Mangionesmith, Ellen J Mackenzie, Mark A Konodi, Frederick P RivaraAbstract:Objective To examine variations in processes of pediatric inpatient Rehabilitation Care related to family-centered Care, management of neurobehavioral and psychosocial needs, and community reintegration after traumatic brain injury. Setting Nine acute Rehabilitation facilities from geographically diverse areas of the United States. Participants A total of 174 children with traumatic brain injury. Design Retrospective chart review. Main measures Adherence to Care indicators (the number of times recommended Care was delivered or attempted divided by the number of times Care was indicated). Results Across facilities, adherence rates (adjusted for difficulty of delivery) ranged from 33.6% to 73.1% (95% confidence interval, 13.4-53.9, 58.7-87.4) for family-centered processes, 21.3% to 82.5% (95% confidence interval, 6.6-36.1, 67.6-97.4) for neurobehavioral and psychosocial processes, and 22.7% to 80.3% (95% confidence interval, 5.3-40.1, 68.1-92.5) for community integration processes. Within facilities, standard deviations for adherence rates were large (24.3-34.9, family-centered domain; 22.6-34.2, neurobehavioral and psychosocial domain; and 21.6-40.5, community reintegration domain). Conclusion The current state of acute Rehabilitation Care for children with traumatic brain injury is variable across different quality-of-Care indicators addressing neurobehavioral and psychosocial needs and facilitating community reintegration of the patient and the family. Individual Rehabilitation facilities demonstrate inconsistent adherence to different indicators and inconsistent performance across different Care domains.
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quality of Care indicators for the structure and organization of inpatient Rehabilitation Care of children with traumatic brain injury
Archives of Physical Medicine and Rehabilitation, 2012Co-Authors: Jennifer M Zumsteg, Stephanie K Ennis, Kenneth M Jaffe, Rita Mangionesmith, Ellen J Mackenzie, Frederick P RivaraAbstract:Abstract Zumsteg JM, Ennis SK, Jaffe KM, Mangione-Smith R, MacKenzie EJ, Rivara FP, and the National Expert Panel for the Development of Pediatric Rehabilitation Quality of Care Indicators. Quality of Care indicators for the structure and organization of inpatient Rehabilitation Care of children with traumatic brain injury. Objectives To develop evidence-based and expert-driven quality indicators for measuring variations in the structure and organization of acute inpatient Rehabilitation for children after traumatic brain injury (TBI) and to survey centers across the United States to determine the degree of variation in Care. Design Quality indicators were developed using the RAND/UCLA modified Delphi method. Adherence to these indicators was determined from a survey of Rehabilitation facilities. Setting Inpatient Rehabilitation units in the United States. Participants A sample of Rehabilitation programs identified using data from the National Association of Children's Hospitals and Related Institutions, Uniform Data System for Medical Rehabilitation, and the Commission on Accreditation of Rehabilitation Facilities yielded 74 inpatient units treating children with TBI. Survey respondents comprised 31 pediatric and 28 all age units. Interventions Not applicable. Main Outcome Measures Variations in structure and organization of Care among institutions providing acute inpatient Rehabilitation for children with TBI. Results Twelve indicators were developed. Pediatric inpatient Rehabilitation units and units with higher volumes of children with TBI were more likely to have: a census of at least 1 child admitted with a TBI for at least 90% of the time; adequate specialized equipment; a classroom; a pediatric subspecialty trained medical director; and more than 75% of therapists with pediatric training. Conclusions There were clinically and statistically significant variations in the structure and organization of acute pediatric Rehabilitation based on the pediatric focus of the unit and volume of children with TBI.
Stephanie K Ennis - One of the best experts on this subject based on the ideXlab platform.
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Rehabilitation following pediatric traumatic brain injury variability in adherence to psychosocial quality of Care indicators
Journal of Head Trauma Rehabilitation, 2014Co-Authors: Stephanie K Ennis, Kenneth M Jaffe, Rita Mangionesmith, Ellen J Mackenzie, Mark A Konodi, Frederick P RivaraAbstract:Objective To examine variations in processes of pediatric inpatient Rehabilitation Care related to family-centered Care, management of neurobehavioral and psychosocial needs, and community reintegration after traumatic brain injury. Setting Nine acute Rehabilitation facilities from geographically diverse areas of the United States. Participants A total of 174 children with traumatic brain injury. Design Retrospective chart review. Main measures Adherence to Care indicators (the number of times recommended Care was delivered or attempted divided by the number of times Care was indicated). Results Across facilities, adherence rates (adjusted for difficulty of delivery) ranged from 33.6% to 73.1% (95% confidence interval, 13.4-53.9, 58.7-87.4) for family-centered processes, 21.3% to 82.5% (95% confidence interval, 6.6-36.1, 67.6-97.4) for neurobehavioral and psychosocial processes, and 22.7% to 80.3% (95% confidence interval, 5.3-40.1, 68.1-92.5) for community integration processes. Within facilities, standard deviations for adherence rates were large (24.3-34.9, family-centered domain; 22.6-34.2, neurobehavioral and psychosocial domain; and 21.6-40.5, community reintegration domain). Conclusion The current state of acute Rehabilitation Care for children with traumatic brain injury is variable across different quality-of-Care indicators addressing neurobehavioral and psychosocial needs and facilitating community reintegration of the patient and the family. Individual Rehabilitation facilities demonstrate inconsistent adherence to different indicators and inconsistent performance across different Care domains.
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quality of Care indicators for the structure and organization of inpatient Rehabilitation Care of children with traumatic brain injury
Archives of Physical Medicine and Rehabilitation, 2012Co-Authors: Jennifer M Zumsteg, Stephanie K Ennis, Kenneth M Jaffe, Rita Mangionesmith, Ellen J Mackenzie, Frederick P RivaraAbstract:Abstract Zumsteg JM, Ennis SK, Jaffe KM, Mangione-Smith R, MacKenzie EJ, Rivara FP, and the National Expert Panel for the Development of Pediatric Rehabilitation Quality of Care Indicators. Quality of Care indicators for the structure and organization of inpatient Rehabilitation Care of children with traumatic brain injury. Objectives To develop evidence-based and expert-driven quality indicators for measuring variations in the structure and organization of acute inpatient Rehabilitation for children after traumatic brain injury (TBI) and to survey centers across the United States to determine the degree of variation in Care. Design Quality indicators were developed using the RAND/UCLA modified Delphi method. Adherence to these indicators was determined from a survey of Rehabilitation facilities. Setting Inpatient Rehabilitation units in the United States. Participants A sample of Rehabilitation programs identified using data from the National Association of Children's Hospitals and Related Institutions, Uniform Data System for Medical Rehabilitation, and the Commission on Accreditation of Rehabilitation Facilities yielded 74 inpatient units treating children with TBI. Survey respondents comprised 31 pediatric and 28 all age units. Interventions Not applicable. Main Outcome Measures Variations in structure and organization of Care among institutions providing acute inpatient Rehabilitation for children with TBI. Results Twelve indicators were developed. Pediatric inpatient Rehabilitation units and units with higher volumes of children with TBI were more likely to have: a census of at least 1 child admitted with a TBI for at least 90% of the time; adequate specialized equipment; a classroom; a pediatric subspecialty trained medical director; and more than 75% of therapists with pediatric training. Conclusions There were clinically and statistically significant variations in the structure and organization of acute pediatric Rehabilitation based on the pediatric focus of the unit and volume of children with TBI.
Gerold Stucki - One of the best experts on this subject based on the ideXlab platform.
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understanding functioning disability and health in rheumatoid arthritis the basis for Rehabilitation Care
Current Opinion in Rheumatology, 2005Co-Authors: Alarcos Cieza, Gerold StuckiAbstract:Purpose of review: To examine the recent literature on rheumatoid arthritis in relation to functioning and disability, highlighting it from the perspective of the biopsychosocial model of functioning, disability, and health of the World Health Organization. This review focuses on longitudinal studies because they clarify associations found in cross-sectional studies and are useful in shedding light on the mechanisms that explain functioning and disability. Recent findings: The studies that contribute best to understanding of functioning and disability in patients with rheumatoid arthritis are studies that (1) incorporate a comprehensive model to integrate different variables of interest, (2) use a longitudinal design to examine the potential casual relationships among the variables, and (3) use hierarchical regression analyses or path analysis to study the relation among variables. Summary: It is time to rethink and redefine what should be measured when addressing functioning and disability of patients with rheumatoid arthritis. The use of a universally agreed framework and classification, such as the International Classification of Functioning, Disability and Health, a universally agreed-on comprehensive list of variables potentially relevant to functioning and disability in rheumatoid arthritis, and a greater focus on functioning-oriented versus disability-oriented perspectives constitute a solid foundation for such a rethinking process.
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Rationale and principles of early Rehabilitation Care after an acute injury or illness.
Disability and rehabilitation, 2005Co-Authors: Gerold Stucki, Marita Stier-jarmer, Eva Grill, John L. MelvinAbstract:Patients hospitalized for an acute illness or injury are at risk of experiencing a significant loss of functioning as defined by the International Classification of Functioning, Disability and Health (ICF). The risk of a significant loss of functioning is increased in critically ill patients, in patients with complications or long-term intensive Care stays, in persons with disabilities or with pre-existing chronic conditions and in the elderly. Early identification of Rehabilitation needs and early start of Rehabilitation can reduce healthCare costs by reducing dependence and nursing Care, length of stay and prevention of disability. Two principles of Rehabilitation for acute and early post-acute Care can be distinguished. First, the provision of Rehabilitation by health professionals who are generally not specialized in Rehabilitation in the acute hospital. And second, specialized Rehabilitation Care provided by an interdisciplinary team. There is large variation how this specialized, typically post-acute Rehabilitation Care is organized, provided, and reimbursed in different countries, regions, and settings. For instance, it may be provided either in the acute hospital or in a Rehabilitation or nursing setting. Most in-patients do not receive specialized Rehabilitation at all during their whole stay in the acute hospital. But, it is important to point out that health professionals working in acute hospitals and who are not specialized in Rehabilitation need to be able to recognize patients' needs for Rehabilitation Care and to perform Rehabilitation interventions themselves or to assign patients to appropriate Rehabilitation Care settings. The principles outlined in this paper can serve as a basis for the development of clinical assessment instruments to describe and classify functioning, health and disability of patients receiving acute or early post-acute Rehabilitation Care.
Ellen J Mackenzie - One of the best experts on this subject based on the ideXlab platform.
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Rehabilitation following pediatric traumatic brain injury variability in adherence to psychosocial quality of Care indicators
Journal of Head Trauma Rehabilitation, 2014Co-Authors: Stephanie K Ennis, Kenneth M Jaffe, Rita Mangionesmith, Ellen J Mackenzie, Mark A Konodi, Frederick P RivaraAbstract:Objective To examine variations in processes of pediatric inpatient Rehabilitation Care related to family-centered Care, management of neurobehavioral and psychosocial needs, and community reintegration after traumatic brain injury. Setting Nine acute Rehabilitation facilities from geographically diverse areas of the United States. Participants A total of 174 children with traumatic brain injury. Design Retrospective chart review. Main measures Adherence to Care indicators (the number of times recommended Care was delivered or attempted divided by the number of times Care was indicated). Results Across facilities, adherence rates (adjusted for difficulty of delivery) ranged from 33.6% to 73.1% (95% confidence interval, 13.4-53.9, 58.7-87.4) for family-centered processes, 21.3% to 82.5% (95% confidence interval, 6.6-36.1, 67.6-97.4) for neurobehavioral and psychosocial processes, and 22.7% to 80.3% (95% confidence interval, 5.3-40.1, 68.1-92.5) for community integration processes. Within facilities, standard deviations for adherence rates were large (24.3-34.9, family-centered domain; 22.6-34.2, neurobehavioral and psychosocial domain; and 21.6-40.5, community reintegration domain). Conclusion The current state of acute Rehabilitation Care for children with traumatic brain injury is variable across different quality-of-Care indicators addressing neurobehavioral and psychosocial needs and facilitating community reintegration of the patient and the family. Individual Rehabilitation facilities demonstrate inconsistent adherence to different indicators and inconsistent performance across different Care domains.
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quality of Care indicators for the structure and organization of inpatient Rehabilitation Care of children with traumatic brain injury
Archives of Physical Medicine and Rehabilitation, 2012Co-Authors: Jennifer M Zumsteg, Stephanie K Ennis, Kenneth M Jaffe, Rita Mangionesmith, Ellen J Mackenzie, Frederick P RivaraAbstract:Abstract Zumsteg JM, Ennis SK, Jaffe KM, Mangione-Smith R, MacKenzie EJ, Rivara FP, and the National Expert Panel for the Development of Pediatric Rehabilitation Quality of Care Indicators. Quality of Care indicators for the structure and organization of inpatient Rehabilitation Care of children with traumatic brain injury. Objectives To develop evidence-based and expert-driven quality indicators for measuring variations in the structure and organization of acute inpatient Rehabilitation for children after traumatic brain injury (TBI) and to survey centers across the United States to determine the degree of variation in Care. Design Quality indicators were developed using the RAND/UCLA modified Delphi method. Adherence to these indicators was determined from a survey of Rehabilitation facilities. Setting Inpatient Rehabilitation units in the United States. Participants A sample of Rehabilitation programs identified using data from the National Association of Children's Hospitals and Related Institutions, Uniform Data System for Medical Rehabilitation, and the Commission on Accreditation of Rehabilitation Facilities yielded 74 inpatient units treating children with TBI. Survey respondents comprised 31 pediatric and 28 all age units. Interventions Not applicable. Main Outcome Measures Variations in structure and organization of Care among institutions providing acute inpatient Rehabilitation for children with TBI. Results Twelve indicators were developed. Pediatric inpatient Rehabilitation units and units with higher volumes of children with TBI were more likely to have: a census of at least 1 child admitted with a TBI for at least 90% of the time; adequate specialized equipment; a classroom; a pediatric subspecialty trained medical director; and more than 75% of therapists with pediatric training. Conclusions There were clinically and statistically significant variations in the structure and organization of acute pediatric Rehabilitation based on the pediatric focus of the unit and volume of children with TBI.