On October 24, 2011 the Rehabilitation & Complex Continuing Care Expert Panel, chaired by Mimi Lowi-Young and Dr. Peter Nord, met to receive the report of the Definitions Working Group. The report focussed on the group’s work to develop a conceptual framework and common set of definitions which will adequately describe the processes used to improve patient function, the categories of care provided, and the locations of care.
The conceptual framework and common set of definitions describe the processes used to improve patient function, the categories of care provided, and the locations of care.
It was based on the following foundational principles:
- Early access to rehabilitative care should be equitable
- All of these programs and services can be described or measured by data elements
- Every program or service can be mapped to a CIHI NRS or CCRS category and to a OHRS category
- The care delivered to every patient/client group, diagnostic cluster and in every location would be guided by best practices where they exist.All programs and services would be delivered in an age appropriate manner (e.g. seniors focused, developmentally appropriate)
- Within each program or service there is flexibility to care for patients/clients as their tolerance for treatment changes to minimize transitions
- There is recognition that clustering patients with similar care needs allows for care delivery by dedicated interprofessional teams which, in turn, leads to better outcomes
Sheila Jarvis, Chair of the Working Group, noted that the framework avoids a bed-based approach and uses a functional improvement focus incorporating the concept of speed of recovery and incorporates the concept of “Assess and Restore” as described in the recently released Walker Report. The framework illustrates how patients can flow in and out of the sector as their needs change.
The framework was “field tested” by experts in the practice of stroke, acquired brain injury, spinal cord injury, paediatrics and orthopedics.
Results of the field testing indicated that experts could see how the framework would be used to describe their patient populations and would be a useful tool in standardizing terminology and approaches to care. The field testing did identify that the developmental paediatric population was not well described by the framework and that further work with this group would be needed.
The Expert Panel offered several observations regarding the framework and the next steps include an updated draft to be presented and the Definitions Working Group will then move on to prepare a final document and implementation plan.
Submitted by: Co-chairs, Rehabilitation & Complex Continuing Care Expert Panel, November 23, 2011