Client-Centred Rehabilitation - Arthritis Community Research ...

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programs such as the Arthritis Self
Management Program provide an
excellent model for involvement of
such organizations in the rehab
system
3) Components of the Rehabilitation System
Our findings echo the need for a
number of the components of the
rehabilitation system identified in Managing
the Seams (Provincial Rehabilitation
Reference Group, MOHLTC, 2000)
particularly those addressing the need for:
multiple, identified access points; service
coordination; and, transition out of
rehabilitation services. These components
all address the need for systems and
processes that make navigating the system
easier for clients.
♦ Structures and systems that facilitate
transitions within the system,
especially between hospital based
services and community services,
need to be developed. These
transitions are not unidirectional.
Options for re-entering or reaccessing
the system also need to be
available. Ideally, clients would have
a key contact person or primary
conduit of information across the
various stages of the rehabilitation
system. This will require:
♦ Educational and information
materials for clients and
providers. Resources will
be required to develop,
evaluate, and distribute
client and provider
educational materials.
♦ Systems to catalogue or
monitor the availability of
community services and
rehabilitation programs.
♦ Research to evaluate health service
delivery models that address
coordination and integration activities
such as effective interteamwork.
♦ Systems to allow sharing of client
information across/between programs
4) In addition to system level structures and
processes, organizational systems and
structures that support client-centred
rehabilitation need to be identified. It is
unrealistic to expect Health Care
Professionals to practice in a client-centred
manner if they are working in a system or
organization that is not client-centred. This
would require:
♦ Resources to support in house
training of clinicians in clientcentred
practice
♦ Reimbursement systems that
reward/allow time to educate the
client. For example, reimbursement
based on the number of visits
rewards the number of clients seen
and does not allow comparison of
services across organizations.
Reimbursement by the hour rewards
clinicians for taking the time to
educate clients and allows
comparison of like services across
organizations. This is particularly
important for clients with chronic
diseases where education about selfmanagement
is critical.
♦ Resources to support the evaluation
of client-centred care through the use
of outcome measures and client
satisfaction questionnaires.
Personnel and structures will need to
be implemented to administer this
data collection and utilize data.
5) Further research is needed to better
understand the processes and outcomes of
client-centred rehabilitation.