Freeman J A, Playford E D, Nicholas R S, Thompson A J
Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, U.K.
J R Coll Physicians Lond. 1996 Jan-Feb;30(1):21-6.
A clinical audit was carried out to determine the impact of multidisciplinary rehabilitation in a specialist neurorehabilitation unit, and to demonstrate how outcome measurement can be incorporated into routine clinical audit. The study describes and interprets the results of one year's activity and outcome in a neurorehabilitation unit. A total of 138 patients were admitted to the 18 bedded unit between April 1994 and March 1995. The main outcome measures were: length of inpatient stay, admission and discharge destination, disability as measured by the Barthel Index and Functional Independence Measure, handicap as measured by the Environmental Status Scale and the Handicap Assessment Scale, and the time spent undertaking the audit. Improvement in disability was demonstrated in 112 (83%) patients and in handicap in 89 (66%) patients. The time taken to analyse the data on a quarterly basis was reduced from 20 hours for the first quarter to 4.5 hours for the last quarter. The results show that multidisciplinary inpatient neurorehabilitation leads to functional improvement in the majority of neurologically impaired patients. Outcome measurement and data collection can be incorporated into routine clinical practice once a sound methodology has been established.
开展了一项临床审计，以确定多学科康复在一家专科神经康复单元中的影响，并展示如何将结果测量纳入常规临床审计。该研究描述并解读了一个神经康复单元一年的活动及结果。1994年4月至1995年3月期间，共有138名患者入住了这个拥有18张床位的单元。主要结果指标包括：住院时间、入院及出院去向、用巴氏指数和功能独立性测量法衡量的残疾程度、用环境状况量表和残疾评估量表衡量的残障程度，以及开展审计所花费的时间。112名（83%）患者的残疾状况得到改善，89名（66%）患者的残障状况得到改善。每季度分析数据所需的时间从第一季度的20小时减少至最后一季度的4.5小时。结果表明，多学科住院神经康复可使大多数神经功能受损患者的功能得到改善。一旦建立了完善的方法，结果测量和数据收集就可以纳入常规临床实践。
