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