Community rehabilitation: 'home versus centre' guidelines for choosing the optimal treatment location

This study aimed to produce indicators and guidelines for clinician use in determining whether individual therapy sessions for community rehabilitation services should be delivered in a home/community-based setting or centre-based setting within a flexible service delivery model. Concept mapping techniques as described by Tochrim and Kane (2005) were utilized within two forums. The first forum consisted of 12 health professionals representing key community rehabilitation disciplines. The second forum consisted of seven clients or carers, who had been part of an active community rehabilitation admission. Each forum produced a concept map of ideas, a table indicating how these ideas tended to favour centre-based or home-based community rehabilitation and the importance of these ideas in choosing the location for community rehabilitation treatment. The five key themes generated were (1) service delivery issues, occupational health and safety; (2) interaction between the goals and the environment; (3) client physical and psychological considerations; (4) service delivery issues, efficiency and (5) service delivery issues, transport issues/logistics. From these themes, a series of specific indicators and associated guidelines were established to direct the decision-making process of staff. Through this research, we now have a tool that facilitates well-informed decisions about the most appropriate, physical environment for individual therapy sessions.