192 Summary processes: 1) environmental aspects; encourages exercises, 2) staff aspects; an interdisciplinary team, 3) organizational aspects; implementing a challenging rehabilitation environment requires a shared vision, and 4) factors outside the ward; such as a well-prepared discharge process. In chapter 5, the data from the first three studies were combined by means of concept mapping into an evidence-based, expert-based and experience-based conceptualization of the challenging rehabilitation environment. For this purpose, 70 statements were extracted from the first 3 studies. 20 (para)medics, 11 nurses and 15 rehabilitants and informal caregivers participated in the study. All participants assessed the statements for relevance and clustered the statements into related topics. Using the statistical procedure of concept mapping, a broadly supported classification into clusters was developed based on this input. This resulted in a division into five clusters; 1) Goals; Aspects that are relevant to the goal setting process. The goals should cover both the inpatient and outpatient period of rehabilitation. These goals should be used as a guidance through the rehabilitation process in terms of the use of therapies and the duration of the rehabilitation process. This cluster also describes that home visits are an integral part of rehabilitation. 2) Rehabilitant and informal caregiver; This cluster focuses on factors related to the rehabilitant and informal caregiver. In a challenging rehabilitation environment, it is important that they are part of the rehabilitation team. For example, they must be involved in formulating the rehabilitation plan, participate in multidisciplinary consultations and have access to and be able to report in the reports. In addition, it is important that rehabilitant and informal caregiver are educated about the medical condition that initiated the rehabilitation, how to deal with associated cognitive problems, and how to manage stimuli and resilience. It is also desirable if they are trained in the skills they need during and after rehabilitation. 3) Staff aspects In a challenging rehabilitation environment, staff should apply an interdisciplinary working method, which implies that there is no hierarchy. All employees are jointly responsible for achieving rehabilitation goals, have a rehabili-
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