Development and Validation of a Patient Classification System for Rehabilitation Hospitals Based on Patient and...

Patient Classification Systems (PCS) are essential for managing resources and staffing in hospitals. However, existing systems are predominantly nursing-centric and fail to capture the interdisciplinary nature and complexity of care in rehabilitation settings, leading to inaccuracies in workload assessment and resource allocation. This study aims to develop and validate a novel, context-specific PCS for rehabilitation hospitals through a participatory approach that actively engages patients and stakeholders.

This mixed-methods study protocol comprises three sequential stages. First, a systematic scoping review following Arksey and O'Malley's framework will identify key PCS components from existing evidence. Second, structured expert panel sessions employing a modified Delphi technique will develop a consensus-based preliminary framework. Third, the developed PCS will undergo rigorous validation through pilot implementation, assessing inter-rater reliability using Cohen's Kappa and criterion validity against established tools, including the Functional Independence Measure (FIM) and Barthel Index, with explicit sample size calculation and reliability criteria.

The study will generate a validated PCS specifically designed for rehabilitation hospital settings through systematic integration of evidence and stakeholder insights. The resulting tool is expected to enhance workload measurement accuracy, promote equitable resource distribution, and ultimately improve both care quality and operational efficiency in rehabilitation contexts.

Stakeholders, including patients, their families, administrators, and multidisciplinary clinical staff, have been engaged from the initial conception of the study. They contributed to defining the research objectives, formulating the scoping review questions, and are integral participants in the co-design and validation stages, ensuring the resulting system is relevant and applicable to real-world practice.