Indicators of Quality Rehabilitation Services for Individuals with Limited English Proficiency: A Three-Round Delphi Study: REHABILITATION FOR PATIENTS WITH LEP.

Objective To obtain expert consensus on indicators of quality rehabilitation services for individuals with limited English proficiency (LEP). Design Three-round Delphi study. Setting Delphi survey conducted online with 30 experts. Most experts worked in adult physical rehabilitation settings and were from Illinois (n=16), with remaining participants from eight other US states or Canadian provinces. Participants Experts had a minimum of two publications on healthcare services for patients with LEP and/or a minimum of five years clinical experience in physical rehabilitation. Of 43 experts (11 researchers, 32 clinicians) emailed the Round One survey, 30 returned complete responses (70% response rate). Of those, 25 completed Round Two, and 24 completed Round Three. Of Round One participants, most (n =21) identified their primary professional activity as clinical, whereas the others worked in research (n =5) or education (n =4). Twenty-four were female. Median age was 43 (range 27-67). Disciplines included occupational therapy (n =14), physical therapy (n =13), psychology (n=1), nursing (n=1), and medicine (n=1). Interventions Not applicable. Main outcome measures Indicators rated on a seven-point Likert scale for importance and feasibility. Interquartile range (IQR) and 95% confidence intervals calculated for importance and feasibility ratings. Indicators with an IQR Results Round One responses were categorized into 15 structural, 13 process and 18 outcome indicators. All 15 structural indicators reached consensus for importance; eight were rated as feasible. All 13 process indicators reached consensus, of which eight were deemed feasible. Sixteen outcome indicators reached consensus, of which seven were deemed feasible. Conclusions This Delphi study identified structural, process, and outcome indicators that can inform delivery and assessment of quality rehabilitation services for individuals with limited English proficiency. Future research should operationalize and measure these quality indicators in clinical practice.