Implementation of the International Classification of Functioning for management a multidisciplinary rehabilitation team work in stroke unit
Shmonin A.A., Kasatkina V.M., Prosvirnina M.S., Maltseva M.N., Melnikova E.V.
First St. Petersburg Pavlov State Medical University., 197022, St. Petersburg, ul. Lev Tolstoy, 6-8,
Purpose: evaluate the effectiveness of a «new» model of rehabilitation for acute stroke using the International Classification of Functioning, Disability and Health (ICF) to manage a multidisciplinary rehabilitation team.
Methods. The project is registered in the ClinicalTrials.gov register under the title: «The Pilot Project Development of the MEdical Rehabilitation System in Russian Federation (DOME)». The design of the study was consecutive. In the 1st phase doctors worked according to the traditional «old» scheme of rehabilitation (n = 130) for Russia. In the second phase, medical organizations worked on a «new» model implementing a problem-oriented multidisciplinary approach (n=130) and using a rehabilitation diagnosis in the ICF categories, which was installed using software «ICF-reader». The study analyzed the quantitative and qualitative characteristics of rehabilitation diagnoses.
Results. The total number of identified problems (domains) in the rehabilitation diagnosis decreased (p<0.001) in a «new» model group. Implementation of the multidisciplinary principle of the team and the use of the software «ICF-reader» leads to a reduction in working time in the rehabilitation process (p<0.001). Using software «ICF-reader» facilitates the elaboration of rehabilitation goals and objectives. The level of disability estimated by the Rankin scale was lower in the group where the ICF was used.
Conclusions. The introduction of the ICF to form a diagnosis results in better recognition of the patient’s problems and better results of rehabilitation.