Retrospective Identification and Qualitative Assessment of Critical Success Factors in Inpatient Orthopaedic Rehabilitation

Exploratory retrospective analysis of routinely collected clinical data and semi-structured qualitative identification of critical success factors in orthopaedic rehabilitation

Topic: Post-treatment care
Focus: Orthopaedic rehabilitation
Method: Advisory board, Co-creation

Duration: November 2022 - December 2023
Status: completed
Location: Tyrol
Funding: OIS Enrichment Fund

What is the project about?

Critical success factors for achieving successful and sustainable rehabilitation outcomes remain largely unexplored. Identifying patients with particularly good, poor, or unexpected rehabilitation outcomes provides the foundation for investigating these factors. A better understanding of the determinants of rehabilitation success has the potential to improve and personalise rehabilitation processes, an increasingly important goal given the growing demand for inpatient rehabilitation.

In the first phase of the project, routinely collected clinical data from inpatient rehabilitation between 2018 and 2022 are analysed retrospectively to identify patients with exceptionally good, poor, or discrepant rehabilitation outcomes.

In the second phase, healthcare professionals from different disciplines and patients who have themselves undergone inpatient rehabilitation at the study centre work together to identify critical success factors by reviewing anonymised patient records. Potential factors associated with rehabilitation outcomes are first collected during collaborative workshops and compiled into a preliminary questionnaire. Participants then independently assess the anonymised patient records, using both closed and open-ended questions to evaluate the perceived importance and impact of the identified factors on rehabilitation outcomes. For each case, they determine whether the outcome was good, poor, or discrepant and identify the factors they consider most influential. These individual assessments are subsequently discussed and reflected upon within the working groups. Each participant reviews and evaluates a total of six anonymised patient records.

What is the goal of the project?

Objectives:
Identify patients with exceptionally good, poor, and discrepant outcomes in inpatient orthopaedic rehabilitation through a retrospective analysis of routinely collected clinical data.
Explore the perspectives and experiences of healthcare professionals and patients to identify critical success factors for rehabilitation using qualitative research methods.
Contribute to the optimisation and personalisation of rehabilitation processes, addressing the growing need for effective inpatient rehabilitation and benefiting both patients and society.

Benefits for participants:
Actively reflect on rehabilitation outcomes during their own rehabilitation journey.
Exchange experiences and perspectives with other patients and healthcare professionals.
Take part in discussions about rehabilitation experiences, including the opportunity to reflect on their own rehabilitation process.
Receive financial compensation for their time and contribution.
Contribute their own perspectives and experiences to the research process.

Who participates in the project?

Eligible participants include rehabilitation patients, physicians, nurses, psychologists, dietitians, occupational therapists, physiotherapists, and the Medical Director.

How are participants involved in the project?

Participants independently identify (critical) success factors and co-develop a questionnaire on factors influencing rehabilitation outcomes. Using this questionnaire, they assess the perceived importance of these factors for the rehabilitation success of six anonymised patient records.

For patients, the research activities include online meetings and three weekly working group sessions held at the Kitzbühel Rehabilitation Centre. Participants are also encouraged to organise their own peer groups, elect a patient representative, and make independent use of a seminar room at the rehabilitation centre for collaborative work. An additional online follow-up session is conducted after the working group meetings.

For healthcare professionals, the project includes three working group sessions: a kick-off meeting, a workshop to identify critical success factors, and a final reflection meeting.

Throughout the project, both patients and healthcare professionals take on the role of co-researchers, working both independently and collaboratively to generate new knowledge about the factors that contribute to successful rehabilitation.

How are participants recruited for the project?

Patients are invited to express their interest in participating when they are admitted for inpatient rehabilitation. During the first project meeting, they receive detailed information about the project and provide their informed consent. Participating staff members receive a comprehensive verbal explanation of the study from a physician who is part of the study team before signing an informed consent form.