Centre for Movement, Occupation and Rehabilitation Sciences (MOReS), Faculty of Health Sciences, Oxford Brookes University, Headington Campus, Oxford OX3 0BP, UK.
Clin Rehabil. 2024 Sep;38(9):1147-1157. doi: 10.1177/02692155241259644. Epub 2024 Jul 25.
Independent organisations monitor the safety and governance of clinical services but do not assess specialist expertise. Peer review can assess service capability but is resource-intense and infeasible.
How can you ensure a service provides safe, effective rehabilitation? You ask them to provide data as evidence that they can be trusted to do so. This article suggests a structured approach to providing data on entrustability.
How is the specialist skill of a doctor in training established? They provide evidence about high-level outcomes (capabilities in practice) related to their speciality. An educational supervisor assesses whether they can be trusted to perform safely and effectively without supervision. The capabilities in practice define their expertise.
A service can use seven high-level rehabilitation service capabilities, based on the clinical capabilities associated with medical training, with observable indicative descriptors, to collect evidence of their rehabilitation approach. A service must also select four to eight high-level competencies indicating they can rehabilitate their patient caseload safely and effectively. These competencies also need indicative descriptors as evidence of their performance in the service; 11 examples are given.
CAPABILITIES.: The seven rehabilitation capabilities are: using the biopsychosocial model, having a multi-professional team, making a person-centred rehabilitation plan, working collaboratively across all boundaries, tailoring treatments to the patient's needs, ensuring staff have specific competencies required for their caseload, and acknowledging and managing uncertainty and complexity.
CONCLUSION.: Service providers could use this structured approach to develop and provide users with evidence of their rehabilitation expertise.
独立组织监测临床服务的安全性和治理情况，但不评估专业知识。同行评审可以评估服务能力，但资源密集且不可行。
如何确保服务提供安全、有效的康复？你要求他们提供数据作为信任他们的证据。本文提出了一种结构化方法来提供可信赖性的数据。
如何确定培训中的医生的专业技能？他们提供与其专业相关的高水平结果（实践中的能力）的证据。教育主管评估他们是否可以在没有监督的情况下安全有效地进行操作。实践中的能力定义了他们的专业知识。
服务可以使用基于与医学培训相关的临床能力的七个高级康复服务能力，并具有可观察的指示性描述符，以收集其康复方法的证据。服务还必须选择四个到八个高级能力，表明他们可以安全有效地为其患者群体进行康复。这些能力也需要指示性描述符作为其在服务中的表现的证据；给出了 11 个示例。
这七个康复能力是：使用生物心理社会模型、拥有多专业团队、制定以人为本的康复计划、跨所有边界协作、根据患者需求定制治疗、确保员工具备其患者群体所需的特定能力，以及承认和管理不确定性和复杂性。
服务提供商可以使用这种结构化方法来发展并向用户提供其康复专业知识的证据。
