Planning the provision of outpatient services in a rehabilitation clinic.

Objective: This study had two aims: (1) to plan the provision of outpatient services in a rehabilitation clinic and increase the efficiency of these services; (2) to identify and evaluate criteria of good clinical practice in outpatient rehabilitation activities in order to avoid transforming the therapy into an assembly line in which the number of services is considered more important than the quality of services delivered.

Design: The authors identified the sequence of activities carried out for each of the services requested and monitored the number of appointments and treatments performed in two four month periods. As part of the process of increasing delivery efficiency and recording services provided, the authors created a computerised database for processing hospital charges.

Main Measures: Quantitative comparison of services delivered during the 4 month sample periods in 1998 and 1999 and evaluation of compliance with identified indicators of good practice related to a series of rehabilitation outpatient therapies, divided into instrumental therapies and manual therapies.

Results: There was an increase in the number of appointments and services without an increase in the number of staff or clinics. In particular, the database introduced in March 1999 contributed to a further improvement with 692 appointments and 7517 therapies. Overall quality of practice was good, although privacy needs to be increased.

Conclusion: The use of quality control instruments improved staff awareness of good clinical practice and highlighted some aspects which could be improved. The efficiency of the outpatient rehabilitation clinic increased.