To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England

Abstract

Purpose: The success of the International Classifcation of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Method: Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and refective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, feld notes and a refective diary. Results: Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. Conclusions: The empirical fndings demonstrate how to make the ICF classifcation a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians.

Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England

“…Therefore, by implementing the ICF in a way previously identified [21] and thereby owned by the participants, the framework and classification was able to change the thinking of clinicians and reinforce the requirement for collaborative working within stroke care.…”

“…An action research framework was selected for this project, the motivations for which have been previously outlined [21]. Action research is characterized by three phases: exploratory; innovatory; and reflective [22].…”

“…A paper previously published in this journal focused on the process aspect. It concluded that in order to adopt the ICF into clinical practice, members of an acute stroke multidisciplinary team needed to adopt it to meet their own needs and adapt some of the terminology and the format of the ICF [21]. Following adaptations, the participants chose to adopt the ICF as a vehicle to develop a transfer of care report, an extract of which is presented in the first paper [21] and a full copy of which can be obtained by contacting the first author.…”

Standardization of Interdisciplinary Clinical Practice and Assessment in Stroke Rehabilitation

“…The team's charter was to critically evaluate stroke assessment and outcome measures within the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework [12][13][14][15][16][17][18][19][20]. This structure assured that the interdisciplinary team assessed the full spectrum of function from individual impairment to participation in society.…”

The Use of the International Classification of Functioning, Disability and Health in Primary Care: Findings of Exploratory Implementation Throughout Life

“…Researchers notice the persisting dominance of individual biomedical disease and deficiency thinking, and difficulties regarding the practical implementation of the scheme. Although the guidelines mention that it is about all people, the framework is mainly applied in specialised rehabilitative settings to persons with specific chronic conditions and disabilities (World Health Organisation, 2001;Helander, 2003;Jelsma, 2009;Cerniauskaite et al, 2011;Tempest et al, 2012;Wiegand et al, 2012).…”