[Quality assurance in the orthopaedic management of neuromuscular diseases]

Increased interest in quality improvement has been brought about by advances in medical technology, health economics and social attitudes over the past decades. Targeted evaluation of infrastructure as well as therapeutic pathways and outcomes can help both patient and carer to achieve optimal treatment processes and a low error rate by means of continuous improvements. While on the one hand there is an urgent need for quality evaluation of health care in disabled persons, on the other this evaluation is challenging since quality of life has to be evaluated for each individual case. Neuroorthopaedic care involves diagnosis, analysis, treatment and rehabilitation of orthopaedic disorders resulting from cerebral and neuromuscular diseases. The aim of treatment is to achieve the best possible quality of life from infancy through to old age, which is measured according to pain-free movement as well as on the ability to actively participate in a social environment. To measure therapeutic outcome, technical methods such as electronic gait analysis, functional scores, questionnaires on subjective satisfaction, as well as economic evaluation of the cost-benefit ratio. Furthermore, medical treatment and technical and logistical processes are evaluated. Evaluation of structure quality provides information on personnel, time, infrastructure, cooperation and knowledge resources.