An evaluation of a post-acute rehabilitation unit after five years of operations

Abstract Introduction The Hospital Organization Guidelines (HOG) recently recommended that Reference Hospitals create Post-Acute Rehabilitation Units (PARU). The authors describe the quality process of a PARU in a University Hospital (UH); this quality process had previously been used in a private rehabilitation hospital. Goals The authors wanted to evaluate the organization of the care provided in their PARU and compare the evaluation results with the results expected at the unit's creation five years earlier. Methods The evaluation indicators were set when the unit was created. These indicators allowed the evaluation of the appropriateness of admissions, the efficiency of the care path and the response to the patients’ rehabilitation and intensive care needs. Results The appropriateness of admission was found to be coherent with the typology of patients admitted (i.e., brain and spinal cord injured patients just discharged from intensive care units). The brain-injured care path was streamlined. The evaluation results raised several questions about the resources provided and about the different needs of post-acute care and rehabilitation. Discussion and conclusion Patient needs must be identified precisely if the weak links of the care path are to be reinforced. The indicators used must be capable of assessing both the quantity and the quality of care. If these indicators lack relevance, or if the health care organization responds incompletely to patient needs, it puts the efficiency of the whole system at stake.