Implementing a system to evaluate quality assurance in rehabilitation in Greece.

BACKGROUND: Use of a widely accepted quality assurance tool is an essential procedure of effective and result-oriented quality management in the rehabilitation sector, and generally in health care and social services, but is still lacking in Greece. OBJECTIVE: This study aims to explore to what extent a Quality Assurance System in Rehabilitation (QASR) in the Greek setting could respond to the needs for quality evaluation of the facilities for people with a disability and to discuss possibilities of its use in rehabilitation organizations, sites and hospitals. METHODS: The European Quality in Social Services (EQUASS) Assurance self-assessment questionnaire was officially translated and used as the basis for the new tool, which consisted of 110 questions in 11 sections on development and 6 questions on its evaluation. This tool was tested in 15 specialized centers. RESULTS: The study received a high (93.75%) response rate. Overall score ranged from 11% to one perfect 100%; 53.3% of the facilities fell short of the preset qualification standards, while 4 (26.7%) were qualified for level-1 accreditation. Evaluation of the QASR questionnaire for the function of the rehabilitation facilities for the disabled was extremely positive. CONCLUSIONS: The EQUASS assurance-based Greek QASR has received proper attention in its first implementation and it was shown promising to assess the needs of sites that would like to improve their services. The next steps are to establish its validity and reliability so that it can significantly emerge as the standard system for guiding policy in the rehabilitation sector in Greece.

Quality assessment systems in rehabilitation services for people with a disability in Greece: a critical review.

BACKGROUND: Despite international interest on quality assessment systems (QAS) and their importance in health care accreditation, implementation of a Rehabilitation Services Quality Measurement System still remains a neglected subject in Greece. OBJECTIVE: To identify appropriate tools for researchers and policy makers to assess the quality of rehabilitation services in Greece, within the current active debate on national health care reform. METHODS: A critical review methodology was undertaken, using a systematic approach, aiming to identify the most appropriate tools in the field. Multi-step strategy was followed to gather relevant data, including bibliographical database, internet and hand searches. RESULTS: Twenty-two studies, articles and documents were identified as meeting all inclusion criteria, representing four QAS, compared according to appropriateness, efficiency, and feasibility for general use. The European Quality in Social Services (EQUASS) was evaluated as meeting all of the desired features, such as proper certification, objective measuring, equality, education and training, established guidelines and person-centered approach. CONCLUSIONS: EQUASS initiative, developed according to European standards and implemented in resource-limited settings, was recognized as the most adaptive and appropriate system for Greek rehabilitation settings. Health policy makers are urged to take findings into consideration in establishing an integrated, quality-assured rehabilitation system throughout the country.