Journal of Rehabilitation Medicine: Special Issue 50-4bokBW | Page 47

Clinical quality management for rehabilitation in Malaysia
Rehabilitation Hospital, rehabilitation services are
provided at state and major district hospitals under
the auspices of MOH’s medical division. Under
MOH’s public health division, physiotherapy and
occupational therapy, but no PRM specialist care,
is offered at the highest level of community-based
health clinics (level 1). The rehabilitation services
provided by MOH are summarized in Table I and
described in detail in Table SII 1 .
Assessments are used according to standards
defined by the MOH. In Hospital Sungai Buloh,
an electronic health record system allows for se-
lection of assessment tools for data entry, whilst
at Cheras Rehabilitation this documentation is still
done manually. While different facilities currently
use different systems, a new health information
system will be implemented across all MOH’s
facilities in the next few years.
Ministry of Human Social Security Organisation
SOCSO is the only centre for vocational rehabilita-
tion, work integration and disability management
in Malaysia under the Ministry of Human Re-
sources. Vocational rehabilitation is prioritized
over compensation. Rehabilitation professionals
document functioning with the wide range of
existing ICF Core Sets, including the ICF Core
Set for Vocational Rehabilitation. Also, SOCSO is
developing a full Rehab-Cycle ® with assessment,
assignment, intervention and evaluation based on
the ICF (23, 24), in light of WHO’s International
Classification of Diseases (ICD) diagnosis and
applying the new International Classification of
Health Interventions (ICHI) (www.who.int/clas-
sifications/ichi/en/) for classifying specific inter-
ventions. SOCSO has also developed standards for
what to document, when and for whom, very much
in line with the envisioned development of clinical
assessment schedules (CLASs) (25) for CQM-R.
Decisions regarding implementation
Based on the widely available expertise in
standardized data collection, the experience of
SOCSO with applying the ICF, the coherent
provision of rehabilitation services across the 3
perspectives, and the openness of the leadership
across the partner organizations to cooperate in
the continuous improvement of individual patient
care and service provision, it was concluded that
the implementation of a CQM-R in Malaysia is
both important and feasible.
To implement CQM-R in Malaysia the fol-
lowing decisions were made: (i) to establish a
governance structure involving the leadership
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from the 3 perspectives; (ii) to decide on a mea-
ningful name for the project; (iii) to develop a
framework for the description of rehabilitation
services and the specification of CLASs for these
services; (iv) to develop ICF-based standards
and ICF-based data collection tools where such
standards and tools are currently missing; (v)
to develop the capacity for applying the ICF in
CQM-R Malaysia; (vi) to align CQM-R Malaysia
with other efforts towards improving quality in
healthcare in Malaysia; (vii) to identify research
opportunities arising from the implementation of
CQM-R Malaysia; and finally, (viii) to develop an
implementation action plan in light of points 1–7
for the time period 2017–2020, with an outlook
of envisioned steps beyond 2020.
GOVERNANCE FOR CLINICAL
QUALITY MANAGEMENT SYSTEM FOR
REHABILITATION MALAYSIA
The governance was established in consultation
with the leaders from the 3 perspectives. The
leadership of the Department of Rehabilitation
Medicine at UM consulted with the dean’s office
at UM (Dean and Deputy Dean for research), the
leadership of Cheras Rehabilitation Hospital con-
sulted with the Director General of the MOH, and
the leadership of SOCSO consulted with the Chief
Executive Officer and the scie