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KCE reports vol. 40 APPENDICES Physiotherapy 5
1.4. QUALITY ASSURANCE AND EVALUATION SYSTEM
1.4.1. Mandatory Programs
As stated above, professionals aspiring to set up a private practice are required to meet minimal
standards regarding their working environment and medical equipment. A registered declaration has
to be filed with the INAMI/RIZIV in this respect. A further additional restriction that can be
interpreted as quality-enhancing is the possibility of barring newly graduated professionals from
RIZIV/INAMI covered care through a central examination. As mentioned above, this has proven to be
very controversial. More specifically, it is claimed by some that the 2005 Flemish examination
overemphasized the importance of legal and technical expertise and thus does not constitute an
appropriate, i.e. quality inducing, means of selection.
Physiotherapists providing reimbursed care are obliged to keep medical patient records (ordered per
prescription). Minimally these records should mention surname, first name, date of birth and
identification of the referring physician, medical data of the prescription, summarized findings of the
physiotherapy examination, a copy of physiotherapy reports on behalf of referring physicians,
envisaged treatment plan and possible posterior changes, interventions per session and dates of
various sessions. At present, there is no obligation to store these records in a digital format.
However, RIZIV/INAMI has made financial allowances for physiotherapists keeping electronic records.
It seems logical that the consistent use of an orderly record system can contribute to a more selfaware
and uniform manner of delivering care for individual practitioners.
1.4.2. Voluntary programs
Contrary to existing programs for physicians, no accreditation program for physiotherapists is
officially recognised by the government 2 .
Currently, continuing development initiatives are developed and centralized by the professionals
associations UKFGB , Union des Kinés Francophones et Germanophones de Belgique and UZK ,
Unie van Zelfstandige Kinesisten, who disseminate related information through their websites. It
would appear these initiatives primarily focus on enhancing individual physiotherapists medical
expertise. Initiatives that aim to raise quality through a more efficient organisation of practices, (selfassessment
schemes followed by (peer-reviewed) audits) seem to be less stressed.
An approach toward physiotherapy that accentuates the scientific underpinning of physiotherapy care
is favoured by the WVVK , Wetenschappelijke Vereniging van Vlaamse Kinesisten. The association
propagates evidence based physiotherapy by offering access to medical databases to its members (at
low cost), organising courses on information retrieval strategies and advocates the use of evidencebased
guidelines in physiotherapy 3 . Further noteworthy developments include peer review projects
and smaller local quality control groups of members.
In collaboration with the UZK professional association, the WVVK has elaborated a quality
management program for physiotherapists financed by the European Social Fund and the Flemish
Community. This program is designed as a teaching package (workshops and lectures) and is modular
in its outline, comprising 4 components (3):
The use of ICT in physiotherapy practices: establishing necessary
hardware, software and user skills.
Rationalisation of patient record keeping in physiotherapy:
developing a patient record that satisfies legal requirements, supports
high standards of care and facilitates communication with various
stakeholders . 4
2
These programs include criteria with regard to size of practice, peer review, patient records and
continuing development.
3
References to various guidelines, including Dutch KNGF and British CSP guidelines, databases and
guideline validation tools can be found at the WVVK website.
4
Stakeholders mentioned by WVVK: referring physician, colleagues, other care providers, consulted
physicians, sickness funds and patients.