J Rehabil Med 2018; 50: 346 – 357
SPECIAL REPORT
IMPLEMENTATION OF CLINICAL QUALITY MANAGEMENT FOR REHABILITATION IN MALAYSIA
Julia Patrick ENGKASAN *, MD 1, 2, Gerold STUCKI *, MD, MS 3 – 5, Sadeeq ALI *, PhD 1, Yusniza Mohd YUSOF, MD 6, 7, Hafez HUSSAIN, MD 8 and Lydia Abdul LATIF, MD 1, 2 From the 1 Department of Rehabilitation Medicine, University of Malaya, 2 University Malaya Medical Centre, Malaysia, 3 Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, 4 Swiss Paraplegic Research( SPF), Nottwil, 5 ICF Research Branch, a cooperation partner within the World Health Organization( WHO) Collaborating Centre for the Family of International Classifications in Germany( at DIMDI), Nottwil, Switzerland, 6 Cheras Rehabilitation Hospital, 7 National Head of Rehabilitation Medicine Services, Ministry of Health, Malaysia and 8 SOCSO Rehabilitation Centre, Malacca, Malaysia * Shared first authorship.
In February 2017, the World Health Organization( WHO) launched its historic” Rehabilitation 2030: A Call for Action”. Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO’ s Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation( SOCSO) Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation( CQM-R Malaysia). The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health( ICF) is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.
Key words: clinical quality management; International Classification of Functioning, Disability and Health; rehabilitation; healthcare system.
Accepted Sep 6, 2017; Epub ahead of print Nov 16 J Rehabil Med 2018; 50: 346 – 357
Correspondence address: Gerold Stucki, Swiss Paraplegic Research( SPF), GZI Institute, SZ-6207 Nottwil, Switzerland. E-mail: gerold. stucki @ paraplegie. ch
In February 2017 the World Health Organization
( WHO) launched its historic” Rehabilitation 2030: A Call for Action”( 1). The call is based on the recognition of urgent need to scale up rehabilitation in health systems worldwide. The demand for rehabilitation services will increase in light of population ageing and the increasing number of persons living with injuries and noncommunicable diseases( 2). In many parts of the world this demand is not being met. WHO’ s call for action is embedded in the United Nations’( UN) strategy for Sustainable Development Goals 2030, in which health is seen as an issue that cuts across all 17 goals. As a basic health strategy, rehabilitation aims to optimize the functioning of individuals and the population and to minimize the experience of disability( 3, 4).
Scaling up rehabilitation in health systems requires concerted actions across all 6 components of WHO’ s Health Systems Framework relevant for health systems strengthening: governance, service delivery, financing, workforce, information, and health interventions( 5). Although each component is important, health information, and a robust health information system, is vital for the success of all components( 6). For rehabilitation, information about functioning is essential( 7), both because the aim of rehabilitation is to optimize functioning, but also because functioning complements mortality and morbidity as the essential health indicators across WHO’ s 5 health strategies( 8).
Functioning information is required for effective rehabilitation at all levels of the health system: at the clinical level of professional – patient interaction; the level of service provision; and the level of policies and programmes( 9). The standardized documentation of functioning at all 3 levels relies on the reference system provided by WHO’ s International Classification of Functioning, Disability and Health( ICF)( 10). The ICF provides the scientific basis for establishing the standards for” what to document”; the ICF Generic Sets and ICF Core Sets for specific health conditions and situations, such as post-acute care doi: 10.2340 / 16501977-2283
This is an open access article under the CC BY-NC license. www. medicaljournals. se / jrm Journal Compilation © 2018 Foundation of Rehabilitation Information. ISSN 1650-1977