Innovations to improve access to outpatient rehabilitation services for persons presenting physical disabilities: results of an environmental scan in Quebec, Canada
Bibliographic record
Abstract
ABSTRACT PURPOSE To identify and characterize innovations implemented to improve access to publicly funded outpatient rehabilitation services for people experiencing physical disabilities, and to explore main barriers and facilitators to implementation. MATERIALS AND METHODS An environmental scan was conducted in the province of Quebec (Canada), combining an online search and semi-structured interviews with key informants. For each innovation, data on implementation context, targeted access issue(s), and indicators used to measure impact were extracted and analyzed descriptively. Interviews were transcribed and analyzed using a mixed inductive/deductive thematic approach to identify barriers and facilitators. RESULTS Twenty-seven innovations, implemented in various regions and settings, were identified. Most of these targeted individuals with musculoskeletal disorders and addressed issues such as long wait times, geographical inequalities, and inappropriate care. Interviews were conducted with informants (n=26) involved in 20 of the innovations. Main barriers to implementation included divergences between actors’ perspectives on the relevance of innovations, their complexity and insufficient resources. Main facilitators were having strong planification and individual’s engagement in the implementation. CONCLUSIONS This study enhances our understanding of the nature and purpose of innovations aimed at improving access to outpatient rehabilitation for people with physical disabilities. Implementation is a complex process that requires careful consideration of multiple factors. Implications for Rehabilitation The results highlight multiple innovations that have been implemented to improve access to rehabilitation services, which may help inform settings seeking such innovations. Identified innovations targeted various dimensions of access, including wait times, geographic barriers, service appropriateness, and equity. Implementing such innovations should consider numerous factors, including administrative burden and the need for adequate technical support.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".