How the Rehabilitation Environment Influences Patient Perception of Service Quality: A Qualitative Study.

How the rehabilitation environment influences patient perception of service quality: A qualitative study.

Filed under: Rehab Centers

Arch Phys Med Rehabil. 2012 Nov 12;
Medina-Mirapeix F, Del Baño-Aledo ME, Oliveira-Sousa SL, Escolar-Reina P, Collins SM

OBJECTIVE: To identify elements of the environment that patients consider when evaluating the quality of a care experience in outpatient rehabilitation settings. DESIGN: A qualitative study using a modified grounded theory approach. Data collection utilized semi-structured interviewing during nine focus groups. SETTING: Three post-acute ambulatory centres in metropolitan Barcelona, Madrid and Seville (Spain). PARTICIPANTS: 57 adults (33 males, 24 females) undergoing outpatient rehabilitation for musculoskeletal conditions/injuries. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Not applicable. RESULTS: Participants perceived the quality of rehabilitation service on the basis of their experiences with environmental factors, including: three physical factors: facility design, ambient conditions and social factors; and four organizational factors: duration of attendance, interruptions during delivery of care, waiting times in the sequence of treatment and patient safety. CONCLUSION: This study identifies the specific environmental attributes that patients consider important when evaluating the quality of outpatient rehabilitation settings and develops a patient-based framework for assessing overall perception of service quality. Further research should work to develop self-report questionnaires about patient experiences with the environment in rehabilitation services to provide empirical and quantitative evidence.
HubMed – rehab

The tibial crest as a practical useful landmark in total knee arthroplasty.

Filed under: Rehab Centers

Knee. 2012 Nov 12;
Tsukeoka T, Lee TH, Tsuneizumi Y, Suzuki M

BACKGROUND: The middle one-third of the tibial crest in the coronal plane and the fibula in the sagittal plane are known as landmarks for extramedullary guides in total knee arthroplasty (TKA). However, there are few foundational anatomic studies about them. We conducted this study to confirm whether these landmarks are reliable. METHODS: We evaluated 100 Japanese knees using 3D imaging software. We examined our data for correlations between the angle of deviation from the mechanical axis and patient-specific factors (i.e. hip-knee-ankle angle, tibial length, tibial bowing, and tibial torsion) to determine whether there are any individual factors affecting their reliability. RESULTS: The mean angles between each of the axes defined by the fibula and the tibial crest with the mechanical axis were 2.9°±0.6° of valgus and 0.7°±0.9° of varus in the coronal plane and 2.2°±0.8° of posterior and 3.6°±1.0° of anterior inclination in the sagittal plane. The middle one-third of the tibial crest (TCL) was revealed as a useful landmark, especially in female patients, who possess TCLs that were within 3° of the tibial mechanical axis in the coronal plane. There were no patient-specific factors strongly affecting reliability of these landmarks. CONCLUSIONS: We can use these landmarks even if the patient has tibial bowing or severe varus deformity. Although not considering soft tissue thickness, our study demonstrated that the tibial crest in the coronal and sagittal planes could be useful guidelines in performing TKAs. LEVEL OF EVIDENCE: II.
HubMed – rehab

A case study of a multiply injured patient.

Filed under: Rehab Centers

Surg Clin North Am. 2012 Dec; 92(6): 1649-60
Roberts J, Weigelt JA

Initial evaluation of severely injured patients requires an organized, rapid, and thorough evaluation of the patient where life-threatening injuries are identified and treated simultaneously. A case study provides the basis for discussion of the management of the multiply injured trauma patient. The ultimate goal in rehabilitation of a multiply injured patient is to return each patient to as much independent function and ability to contribute to society as possible.
HubMed – rehab

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