Journal of Rehabilitation Medicine: Special Issue 50-4bokBW | Page 53

Clinical quality management for rehabilitation in Malaysia
with the developers of ICSO-R will ensure that the
description of rehabilitation services in Malaysia
is closely aligned with ICSO-R. In turn, the Ma-
laysian experience in applying the current version
of ICSO-R is expected to provide valuable lessons
on how to improve the classification.
Secondly, the method for developing CLASs
currently relies on a single experimental work-
shop (25). Consequently, this methodology will
need to be developed further during the consensus
conferences planned for 2018. The experience
of conducting the consensus conferences in
Malaysia is expected ultimately to inform the
development of a protocol that can be used by
countries worldwide aiming for the system-wide
implementation of the ICF in rehabilitation as
well as the implementation of a national CQM-R.
Thirdly, the imple mentation will rely on both
paper-based and electronic documentation, de-
pending on the IT options offered at the different
facilities. Having 2 different modes of documen-
tation provides the opportunity to qualitatively
study the similarities and differences, as well as
the utility of these 2 implementation modes in
implementing the ICF and CQM-R. The lessons
learned from Malaysia can then be shared with
the international scientific community. Moreover,
the experience of integrating ICF tools in existing
electronic health record systems could provide
valuable practical information to other medical
specialties interested in the documentation of
functioning including primary care, geriatrics
and anaesthesiology.
The project also provides the opportunity
to further strengthen rehabilitation in practice,
science and governance, and to spearhead the
implementation of the ICF in health information
systems, both at the clinical and national statis-
tical level. It also emphasizes the importance of
functioning information beyond the rehabilitation
community to stakeholders of the healthcare sys-
tem at large, including policymakers.
CONCLUSION
The proposal for implementing the ICF in reha-
bilitation and CQM-R in Malaysia presented in
this paper is only the starting point for scaling up
rehabilitation services in Malaysia. It promotes
the flexibility of adding rehabilitation services
or modifying currently offered services and the
continuous improvement of the health system at
all levels by learning from its implementation
experience. Last but not least, in line with WHO’s
”Rehabilitation 2030: A Call for Action”, the
355
Malaysian proposal can also serve as a model
framework for other countries that are striving
to scale up rehabilitation services.
ACKNOWLEDGEMENTS
UM and UMMC
• We express our gratitude to the Dean of the Faculty
of Medicine, Professor Dr Adeeba Kamarulzaman,
and the Deputy Dean (Research), Professor Yvonne
Lim Ai Lian, of the University of Malaya for enabling
the project and, more specifically, by enabling the
situation analysis in January 2017 through a Visiting
Professorship and for facilitating the projects align-
ment with the MOH.
• We thank the Deputy Director (Clinical) of UMMC,
Professor Nazirah Hasnan, for supporting the project
at the hospital level and specifically for the support
to envision the inclusion of the ICF Generic Set as a
basic documentation of functioning in the electronic
health record system accessible to all healthcare
professionals at UMMC.
• We thank PRM-consultants Dr Mazlina Mazlan, Dr
Chung Tze Yang, Dr Anwar Suhaimi, department
clinical manager Soh Say Beng, the head of Phy-
siotherapy Division Leena Lee Poh Chen, the head of
Occupational Therapy Division Ruzina Baharuddin,
the head of Speech Therapy Division Lee Mei Hui
and the team members of the UMMC Department of
Rehabilitation Medicine for the thoughtfully prepared
presentations of services and research agendas as
well as critical feedback and willingness to support
the implementation of CQM-R.
• We thank Professor Sajaratulnisah Othman from the
Department of Primary Care Medicine for the sug-
gestion to use the term generic set rather than reha-
bilitation set to increase the acceptance of ICF-based
documentation across services at UMMC, including
at the primary care level.
MOH
• We thank the Director General of the Health Malaysia
for his permission to publish this article.
• We express our gratitude to the director of Cheras
Rehabilitation Hospital, Dr Roslan Johari bin Dato’
Mohd Ghazali, and the Director General of the MOH
for considering the implementation of CQM-R.
• We thank the heads of the rehabilitation services at
Cheras Rehabilitation Hospital, Dr Yusniza Mohd
Yusof, Dr Chern Pei Ming, Dr Norhayati Hussein
and Dr Norazlina Abdul Aziz, for the presentation
of their services and support of CQM-R.
• We thank Dr Akmal Hafizah Zamli and Dr Nor Azira
Ismail and their teams at the Department of Reha-
bilitation Medicine, Sungai Buloh Hospital, for the
presentation of their services, the demonstration of
the possibilities of the electronic health record system
and support of CQM-R.
J Rehabil Med 50, 2018