Implementation of an ICF-based project/program in a pediatric neuro-rehabiltation hospital: follow-up evaluation by stakeholders

Abstract

Purpose: We follow-up on the experience started 3 years ago with the introduction in a pediatric neurorehabilitation hospital of an ICF-CY based form for rehabilitation projecting/programming, by probing the impact that this process had on stakeholders to establish its long term cost/benefit ratio.

Methods: Two hundred and two rehabilitation projects/programs forms for children with various health conditions admitted for intensive rehabilitation were completed in 36 months. Assessment was carried out by (i) evaluating the compliance with the new process design, (ii) assessing the resource consumption and (iii) appraising the perceived change in terms of added quality. A structured questionnaire built by clustering statements about added quality determinants in rehabilitation expressed by team members and families, explored the perceived change in the rehabilitation process associated with the introduced form with a 0–5 Likert-type scaling.

Results: (i) Most projects/programs forms were filled appropriately, allowing the link of functional problems, objectives, rehabilitation activities, and outcome indicators. (ii) No additional resources were needed to implement the process. (iii) Questionnaire scores were 3.25 SD 0.2 for team members and 4.05 SD 0.2 for families, showing moderate to relevant appreciation in particular by families.

Conclusions: The results confirmed the feasibility of ICF implementation in the clinical setting. ICF based project/program was appreciated by both team members and caregivers as adding quality to the rehabilitation process. These results further encourage the implementation of ICF based tools in the clinical sector.

Implications for Rehabilitation

• International Classification of Functioning, disability and health (ICF) provides an efficient and sustainable framework to systematize information in a childhood neurorehabilitation hospital setting.

• The use of an ICF-based monitoring form is seen as an improvement in quality of rehabilitation process by both team members and families, even though team members and families perceive quality in rehabilitation from different perspectives.

• The changes brought about by the ICF-based forms are valued more positively by families than team members, especially as it improves information sharing.

Keywords::

• ICF
• ICF-CY
• perceived quality
• rehabilitation process

Acknowledgments

This paper was presented under the title ‘Implementing ICF in clinical rehabilitation: impact on the process and the team’ as part of the Symposium ‘Think Before You Measure’. University of Sydney, June 29, 2011.

Declaration of Interest: The authors report no declarations of interest.