Neuderth S, Saupe-Heide M, Brückner U, Gross B, Wenderoth N, Vogel H
Universität Würzburg, Arbeitsbereich Rehabilitationswissenschaften am Institut für Psychotherapie und Medizinische Psychologie, Würzburg, Germany.
Rehabilitation (Stuttg). 2012 Jun;51(3):171-80. doi: 10.1055/s-0031-1280804. Epub 2011 Oct 5.
Visitation procedures are an established method of external quality assurance. They have been conducted for many years in the German statutory pension insurance's medical rehabilitation centres and have continuously been refined and standardized. The overall goal of the visitation procedure implemented by the German statutory pension fund is to ensure compliance with defined quality standards as well as information exchange and counselling of rehabilitation centres. In the context of advancing the visitation procedure in the German statutory pension funds' medical rehabilitation centres, the "Visit II" Project was initiated to evaluate the perspectives and expectations of the various professional groups involved in the visitations and to modify the materials used during visitations (documentation form and manual). Evaluation data from the rehabilitation centres visited in 2008 were gathered using both written surveys (utilization analysis) and telephone-based interviews with administration managers and chief physicians. The utilization analysis procedure was evaluated with regard to its methodological quality. In addition, the pension insurance physicians in charge of patient allocation during socio-medical assessment were surveyed with regard to potential needs for revision of the visitation procedure. Data collection was complemented by expert panels with auditors. Interviews with users as part of the formative evaluation of the visitation procedure showed positive results regarding acceptance and applicability of the visitations as well as of the utilization analysis procedures. Various suggestions were made with regard to modification and revision of the visitation materials, that could be implemented in many cases. Documentation forms were supplemented by current scientifically-based topics in rehabilitation (e. g., vocationally oriented measures), whereas items with minor relevance were skipped. The manual (for somatic indications) was thoroughly revised. The transparent presentation of visitation processes and visitation criteria has proven to be a useful basis for strengthening the cooperation between the statutory pension insurance funds and the rehabilitation centres. Moreover, it is a helpful tool for the systematic and continuous advancement of this complex method by including all parties involved.
巡查程序是一种既定的外部质量保证方法。它在德国法定养老保险的医疗康复中心已实施多年，并不断得到完善和规范。德国法定养老基金实施巡查程序的总体目标是确保康复中心遵守既定的质量标准，以及进行信息交流和咨询。在推进德国法定养老基金医疗康复中心巡查程序的背景下，启动了“巡查二期”项目，以评估参与巡查的各专业团体的观点和期望，并修改巡查期间使用的材料（文件表格和手册）。通过书面调查（使用情况分析）以及与行政管理人员和主任医师进行电话访谈，收集了2008年被巡查康复中心的评估数据。对使用情况分析程序的方法质量进行了评估。此外，还就巡查程序修订的潜在需求，对负责社会医疗评估中患者分配的养老保险医生进行了调查。通过与审计人员组成的专家小组进行补充数据收集。作为巡查程序形成性评估的一部分，与用户进行的访谈显示，巡查以及使用情况分析程序在接受度和适用性方面取得了积极成果。针对巡查材料的修改和修订提出了各种建议，其中许多建议在很多情况下都可以实施。文件表格补充了当前基于科学的康复主题（例如，以职业为导向的措施），而相关性较小的项目则被跳过。手册（针对躯体适应症）进行了全面修订。巡查过程和巡查标准的透明呈现已被证明是加强法定养老基金与康复中心之间合作的有用基础。此外，通过纳入所有相关方，它是系统且持续推进这一复杂方法的有用工具。
