A team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation set in clinical evaluation

Abstract

Objective To develop a team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) in clinical evaluation. Design A Delphi study. Subjects Experts from rehabilitation institutions in China including physicians, nurses, physiotherapists and occupational therapists. Methods A 2-round Delphi survey and expert panel discussion were used to generate the team approach. Firstly, the candidate types of professionals for team rating were chosen through expert panel discussion. A carefully selected group of participants was then asked to score the suitability of physicians, nurses, or other candidate therapists for each category’s rating, applying the International Classification of Functioning, Disability and Health Rehabilitation Set in clinical evaluation. After initial assignment of category to types of professionals, a second round Delphi survey was conducted to quantify the professionals’ agreement with the category assignments and generate a final team evaluation approach. Results Thirty of the category assignments achieved consensus. The final team evaluation approach assigned 6 categories to physicians to evaluate, 7 categories to nurses, 9 categories to physiotherapists, and 8 to occupational therapists. Conclusion Such a team evaluation approach could facilitate implementation of the ICF-RS in clinical settings and provide a more convenient assessment tool for professionals. LAY ABSTRACT As the Chinese International Classification of Functioning, Disability and Health Rehabilitation Set became widely used in rehabilitation institutions in China, it was found to be timeconsuming and inefficient for a single rater to complete the entire evaluation in a single setting. Team evaluation provides an alternative team approach for busy professionals, especially when used to evaluate patients with complex problems or poor communication ability. The whole set of 30 evaluation categories was divided among a hypothetical team consisting of a physician, a nurse, a physiotherapist and an occupational therapist, with 6 categories assigned to the physician, 7 to the nurse, 9 to the physiotherapist, and 8 to the occupational therapist. Each professional in the team rated categories closely related to their daily work. The team evaluation approach promises to better share the evaluation workload, perhaps improving the accuracy of evaluations and strengthening interdisciplinary collaboration in the clinic.

Responsiveness of the International Classification of Functioning, Disability And Health (ICF) Clinical Functioning Information Tool (ClinFIT) in Routine Clinical Practice in an Australian Inpatient Rehabilitation Setting

“…Despite multiple studies evaluating the psychometric properties, reliability and validity of the ICF Rehabilitation-30 Set (3,22,(24)(25)(26)37), only a few studies have examined its application for assessment of clinical outcomes in inpatient rehabilitation programmes (23,34). Consistent with the findings of this study, Kinoshita et al showed marked improvement in the EI of the ICF Rehabilitation Set at discharge after a structured inpatient multidisciplinary rehabilitation programme in stroke patients (n = 108), with medium to large effect sizes (34) and that the improvement in the ICF Rehabilitation Set correlated significantly with FIM scores (34).…”

Agreement Between Single Raters and Team Rating When Applying the International Classification of Functioning, Disability and Health’s Rehabilitation Set

“…In the single-rater approach, either a physician or therapist served as the single rater. The others formed a team of 4 raters with 1 physician, 1 nurse, 1 physiotherapist and 1 occupational therapist as suggested in the Delphi survey ( 19 ). All of the raters had passed a 2-day unified and rigorous training course, which included theoretical study and clinical practice.…”

“…In contrast, the team evaluation version of the ICF-RS consists of 4 parts ( 19 ). In this study 6 categories were assigned to the physician, 7 to the nurse, 9 to the physical therapist (PT), and 8 to the occupational therapist (OT) (see Table I ).…”

“…To address these difficulties, a Delphi expert survey was conducted aiming to develop a new team evaluation approach rather than the default single rater approach to implementing the ICF-RS. It groups the 30 categories into 4 groups to be rated by a physician, a nurse, a physiotherapist, or an occupational therapist according to the content, with 6 categories assigned to the physician, 7 to the nurse, 9 to the physiotherapist, and 8 to the occupational therapist ( 18 , 19 ). Using this team rating approach, each professional is responsible for evaluating the categories closest to their routine practice.…”

Integrating a New Dietetic Care Process in a Health Information System: A System and Process Analysis and Assessment

“…Numerous articles can be found regarding ICF. These describe how the ICF framework can be used in multidisciplinary health care [ 13 , 14 , 15 , 16 , 17 , 18 ] and discuss the development and validation of ICF Core Sets (sets of ICF categories relevant for patients with a certain heath condition) to facilitate multidisciplinary assessment [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Articles compare the content of instruments to measure functioning of patients [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ] and describe the linking of problems experienced from a patient perspective in daily life [ 36 , 37 , 38 ].…”