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Implementation of an ICF-based project/program in a pediatric neuro-rehabiltation hospital: follow-up evaluation by
Andrea Martinuzzi1, Elena Carraro, Elisa Petacchi
1E. Medea Scientific Institute, Conegliano Research Centre, Research Branch of the Italian WHO-FIC CC, Conegliano, Italy.
Insights
Implementing the International Classification of Functioning, Disability and Health - Children and Youth version (ICF-CY) form in pediatric neurorehabilitation improved rehabilitation programming. Families particularly appreciated the enhanced quality of care, with no additional resources required.
Area of Science:
- Pediatric Neurorehabilitation
- Health Services Research
- Clinical Informatics
Background:
- The International Classification of Functioning, Disability and Health - Children and Youth version (ICF-CY) provides a standardized framework for describing health and functioning.
- Implementing new clinical tools requires evaluation of their impact on processes, resources, and stakeholder satisfaction.
- This study assesses the long-term impact of an ICF-CY based form for rehabilitation programming in a pediatric setting.
Observation:
- A 3-year follow-up evaluated 202 ICF-CY based rehabilitation project/program forms for children undergoing intensive rehabilitation.
- Compliance with the ICF-CY form was high, enabling clear links between functional problems, objectives, interventions, and outcomes.
- Resource consumption analysis indicated no additional resources were needed for implementation.
Findings:
- The ICF-CY form facilitated appropriate linkage of rehabilitation components, enhancing program structure.
- Stakeholder feedback, measured via a Likert-scale questionnaire, showed positive perceptions of quality improvement.
- Team members reported a mean score of 3.25 (SD 0.2), while families reported a higher mean score of 4.05 (SD 0.2).
Implications:
- The findings demonstrate the feasibility and value of integrating ICF-CY based tools into routine clinical practice.
- The positive reception by families suggests an enhanced perceived quality of care and patient-centeredness.
- This study supports the broader adoption of ICF-CY frameworks to improve pediatric neurorehabilitation programming and outcomes.
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.
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