Quality measures for inpatient medical rehabilitation using the Delphi method

OBJECTIVE: Using a Delphi method, we investigated quality measures (QMs) for use in inpatient rehabilitation facilities. DESIGN: After literature review, an initial search of 509 articles yielded 31 QMs. These were presented and evaluated for content, applicability, and diagnostic specification and considered over three total Delphi rounds by an expert panel. These measures were either accepted, rejected, recommended for modification, or supplemented. After two more subsequent rounds of expert consideration, the panelists arrived at a consensus list of QMs they judged appropriate for inpatient medical rehabilitation. SETTING: Video conference- based expert Delphi panel. PARTICIPANTS: Convenience sample of six expert panelists with published expertise in rehabilitation or quality measures who agreed to serve without remuneration. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Quality measures for use in inpatient medical rehabilitation hospitals. RESULTS: Fifteen consensus QMs were categorized thematically as relating to the avoidance of worsened health status during inpatient medical rehabilitation, transitions of care, effectiveness, persistence of improved health status after inpatient rehabilitation facilities discharge, and patient comprehension. CONCLUSIONS: This Delphi study provides clinicians, administrators, and policy makers with multidimensional, clinically relevant measures that reflect the quality of inpatient medical rehabilitation. The measures are practical and can be implemented or studied additionally for further refinement.