Reorganizing pediatric rehabilitation services to improve accessibility: do we sacrifice quality?
BACKGROUND
The impact of a pediatric rehabilitation service delivery reorganization to improve access to services on parents' and service providers' perception of service quality was evaluated. Child-, family-, service- and service provider-related characteristics possibly associated with these perceptions were explored.


METHODS
Perceptions were measured using the Measure of Processes of Care tools and open ended questions before (2007), during (2008) and following (2009) service reorganization. Child and family characteristics, services received and service provider data were documented. Mean MPOC scores were compared over time (ANOVAs and Generalized Estimating Equations) and t-tests, correlations and ANOVAs determined whether the characteristics influenced scores.


RESULTS
Families' (n = 222) and service providers' (n = 129) perceptions of quality were high in 2007 (3.67 to 6.31/7) and remained high over the next 2 years (p >or= 0.16). Two MPOC domain scores (Respectful care and Providing general information) were consistently scored the highest (mean >or= 5.66/7) and the lowest (mean <or= 4.75/7), respectively. Families with more education and those with children 12-21 years old tended to attribute lower MPOC scores. Participants were generally satisfied with the new service model and recommendations included improving information exchange.


CONCLUSIONS
Results suggest that it is possible to reorganize pediatric rehabilitation services while maintaining quality.
Camden
Chantal
C
Estrie Rehabilitation Center, Sherbrooke, Québec, Canada. chantal.camden@gmail.com
Swaine
Bonnie
B
Tétreault
Sylvie
S
Brodeur
Marie-Michèle
MM
D000293:Adolescent; D000328:Adult; D002648:Child; D003258:Consumer Behavior; D017598:Efficiency, Organizational; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D010371:Pediatric Nursing / Q000458:organization & administration*; D015397:Program Evaluation; D011787:Quality of Health Care; D011792:Quebec; D019145:Rehabilitation Nursing / Q000458:organization & administration* / Q000592:standards; D055815:Young Adult