Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Challenges and potential improvements in the admission process of patients with spinal cord injury in a specialized rehabilitation clinic – an interview based qualitative study of an interdisciplinary team

Authors: Fabian Röthlisberger, Stefan Boes, Sara Rubinelli, Klaus Schmitt, Anke Scheel-Sailer

Published in: BMC Health Services Research | Issue 1/2017

Login to get access

Abstract

Background

The admission process of patients to a hospital is the starting point for inpatient services. In order to optimize the quality of the health services provision, one needs a good understanding of the patient admission workflow in a clinic. The aim of this study was to identify challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic from the perspective of an interdisciplinary team of health professionals.

Methods

Semi-structured interviews with eight health professionals (medical doctors, physical therapists, occupational therapists, nurses) at the Swiss Paraplegic Centre (acute and rehabilitation clinic) were conducted based on a maximum variety purposive sampling strategy. The interviews were analyzed using a thematic analysis approach.

Results

The interviewees described the challenges and potential improvements in this admission process, focusing on five themes. First, the characteristics of the patient with his/her health condition and personality and his/her family influence different areas in the admission process. Improvements in the exchange of information between the hospital and the patient could speed up and simplify the admission process. In addition, challenges and potential improvements were found concerning the rehabilitation planning, the organization of the admission process and the interdisciplinary work.

Conclusion

This study identified five themes of challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic. When planning adaptations of process steps in one of the areas, awareness of effects in other fields is necessary. Improved pre-admission information would be a first important step to optimize the admission process. A common IT-system providing an interdisciplinary overview and possibilities for interdisciplinary exchange would support the management of the admission process. Managers of other hospitals can supplement the results of this study with their own process analyses, to improve their own patient admission processes.
Appendix
Available only for authorised users
Literature
1.
Kirchberger I, Biering-Sørensen F, Charlifue S, Baumberger M, Campbell R, Kovindha A, et al. Identification of the most common problems in functioning of individuals with spinal cord injury using the International Classification of Functioning, Disability and Health. Spinal Cord. 2010;48(3):221–229.
2.
New PW, Scivoletto G, Smith É, Townson A, Gupta A, Reeves RK, et al. International survey of perceived barriers to admission and discharge from spinal cord injury rehabilitation units. Spinal Cord. 2013;51(12):893–7.CrossRefPubMed
3.
Goodwin-Wilson C, Watkins M, Gardner-Elahi C. Developing evidence-based process maps for spinal cord injury rehabilitation. Spinal Cord. 2010;48(2):122–7.CrossRefPubMed
4.
5.
Rotter T, Kinsman L, James E, Machotta A, Gothe H, Willis J, et al. Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database Syst Rev. 2010;17(3):CD006632. doi:10.​1002/​14651858.​CD006632.​pub2.
6.
Lepaux DJ. Improving the quality of the admission process in a French psychiatric hospital: impact on the expertise of the professional team. Int J Qual Health Care. 2001;13(4):333–8.CrossRefPubMed
7.
Keithly S, Muldoon M, Cheng D, Vish N, Dejong SM, Adams J. The preadmission packet: a strategy that benefits patients and nurses during the admission process. Proc Baylor Univ Med Cent. 2011 Oct;24(4):299–301.
8.
Sayah A, Rogers L, Devarajan K, Kingsley-Rocker L, Lobon LF. Minimizing ED Waiting Times and Improving Patient Flow and Experience of Care. Emerg Med Int. 2014;2014:981472.CrossRefPubMedPubMedCentral
9.
Ahn H, Singh J, Nathens A, MacDonald RD, Travers A, Tallon J, et al. Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. J Neurotrauma. 2011;28(8):1341–61.CrossRefPubMedPubMedCentral
10.
Middleton PM, Davies RS, Anand S, Reinten-Reynolds T, Marial O, Middleton JW. The pre-hospital epidemiology and management of spinal cord injuries in New South Wales: 2004–2008. Injury. 2012;43(4):480–5.CrossRefPubMed
11.
Braun V. Successful qualitative research: a practical guide for beginners. London: SAGE; 2013. p. 382.
12.
World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization; 2001. p. 299.
13.
Stucki G, Kostanjsek N, Ustün B, Cieza A. ICF-based classification and measurement of functioning. Eur J Phys Rehabil Med. 2008;44(3):315–28.PubMed
14.
Rauch A, Cieza A, Stucki G. How to apply the International Classification of Functioning, Disability and Health (ICF) for rehabilitation management in clinical practice. Eur J Phys Rehabil Med. 2008;44(3):329–42.PubMed
15.
Tracy SJ. Qualitative Quality: Eight “Big-Tent” Criteria for Excellent Qualitative Research. Qual Inq. 2010;16:837–51.CrossRef
16.
Sharwood LN, Stanford R, Middleton JW, Burns B, Joseph A, Flower O, et al. Improving care standards for patients with spinal trauma combining a modified e-Delphi process and stakeholder interviews: a study protocol. BMJ Open. 2017;7(1):e012377.CrossRefPubMedPubMedCentral
17.
Schulz R, Czaja SJ, Lustig A, Zdaniuk B, Martire LM, Perdomo D. Improving the quality of life of caregivers of persons with spinal cord injury: a randomized controlled trial. Rehabil Psychol. 2009;54(1):1–15.CrossRefPubMedPubMedCentral
18.
Gandara E, Moniz T, Ungar J, Lee J, Chan-Macrae M, O’Malley T, et al. Communication and information deficits in patients discharged to rehabilitation facilities: an evaluation of five acute care hospitals. J Hosp Med. 2009;4(8):E28–33.CrossRefPubMed
19.
Gesundheits- und Fürsorgedirektion des Kantons Bern. Leitfaden zur Schweigepflicht von Gesundheitsfachpersonen. 2014.
20.
Werner A, Steiner LR. Use of the ICF model as a clinical problem-solving tool in physical therapy and rehabilitation medicine. Phys Ther. 2002;82(11):1098–107.
21.
Young CA, Manmathan GP, Ward JCR. Perceptions of goal setting in a neurological rehabilitation unit: a qualitative study of patients, carers and staff. J Rehabil Med. 2008;40(3):190–4.CrossRefPubMed
22.
Holliday RC, Cano S, Freeman JA, Playford ED. Should patients participate in clinical decision making? An optimised balance block design controlled study of goal setting in a rehabilitation unit. J Neurol Neurosurg Psychiatry. 2007;78(6):576–80.CrossRefPubMedPubMedCentral
23.
Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, et al. Shared Decision Making: A Model for Clinical Practice. J Gen Intern Med. 2012;27(10):1361–7.CrossRefPubMedPubMedCentral
24.
McCaffery KJ, Smith SK, Wolf M. The challenge of shared decision making among patients with lower literacy: a framework for research and development. Med Decis Making. 2010;30(1):35–44.CrossRefPubMed
25.
Rentsch HP, Bucher P, Dommen Nyffeler I, Wolf C, Hefti H, Fluri E, et al. The implementation of the “International Classification of Functioning, Disability and Health” (ICF) in daily practice of neurorehabilitation: an interdisciplinary project at the Kantonsspital of Lucerne, Switzerland. Disabil Rehabil. 2003;25(8):411–21.CrossRefPubMed
26.
Jeeyae Choi HK. A workflow-oriented framework-driven implementation and local adaptation of clinical information systems: a case study of nursing documentation system implementation at a tertiary rehabilitation hospital. Comput Inform Nurs. 2012;30(8):409–14. quiz 415–6CrossRefPubMed
27.
Herrman KH, Kirchberger I, Stucki G, Cieza A. The comprehensive ICF core sets for spinal cord injury from perspective of occupational therapists: a worldwide validation study using the Delphi technique. Spinal Cord. 2011;49(5):600–13.CrossRef
Metadata
Title
Challenges and potential improvements in the admission process of patients with spinal cord injury in a specialized rehabilitation clinic – an interview based qualitative study of an interdisciplinary team
Authors
Fabian Röthlisberger
Stefan Boes
Sara Rubinelli
Klaus Schmitt
Anke Scheel-Sailer
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2399-5

Other articles of this Issue 1/2017

BMC Health Services Research 1/2017 Go to the issue

Research article

“We and the nurses are now working with one voice”: How community leaders and health committee members describe their role in Sierra Leone’s Ebola response

Study protocol

Assessing the link between implementation fidelity and health outcomes for a trial of intensive case management by community health workers: a mixed methods study protocol

Research article

Using technology to engage hospitalised patients in their care: a realist review

Research article

Patient perspectives on continuity of care: adaption and preliminary psychometric assessment of a Norwegian version of the Nijmegen Continuity Questionnaire (NCQ-N)

Research article

Cultural elements underlying the community health representative – client relationship on Navajo Nation

Research article

The research activities of Ontario’s large community acute care hospitals: a scoping review