title: Process of pulmonary rehabilitation and program organization.
abstract: Pulmonary rehabilitation programs are highly directed to return patients suffering from chronic lung diseases to a state of self-help. These programs are largely organized as temporary interventions in a highly fragmented delivery care system for patients with chronic respiratory conditions. In an optimal health care organizational structure, pulmonary rehabilitation needs to be considered as an essential part of an individualized, integrated care process, organized from the vantage point of the patient and the patients'health continuum. Pulmonary rehabilitation programs need to become organized as patient-centered care, respectful of and responsive to individual patient preferences, needs and values. Partnering and communication skills are considered as drivers for successful rehabilitation. Assessment is considered as the cornerstone to evaluate the individual needs and problems in order to develop an individualized intervention. Pulmonary rehabilitation programs need to move away from a supply-driven functional organizational structure towards integrated structures, including the full range of medical expertise, technical skills and specialized facilities needed to compete on added value in the management of patients with chronic respiratory diseases.
authors.affiliation: Department of Respiratory Medicine, Maastricht University Hospital, Maastricht, The Netherlands. e.wouters@mumc.nl
authors.forename: E F M
authors.initials: EF
authors.lastname: Wouters
authors.forename: I M L
authors.initials: IM
authors.lastname: Augustin
mesh_terms: D002908:Chronic Disease; D002983:Clinical Competence; D003142:Communication; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004185:Disability Evaluation; D006801:Humans; D008171:Lung Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D018802:Patient-Centered Care / Q000458:organization & administration*; D010817:Physician-Patient Relations; D012648:Self Care