Sentrum vir Gesondheidsberoepe Onderwys Centre for Health Professions EducationFakulteit Geneeskunde en Gesondheidswetenskappe Faculty of Medicine and Health Sciences

International Classification of Functioning,

Disability and Health (ICF):

An Interprofessional Care/Collaboration Framework for transformative interprofessional education.

Dr Stefanus SnymanStellenbosch University: Interprofessional Education and PracticeWHO: Functioning and Disability Reference Group & Education and Implementation CommitteeDr Klaus von Pressentin: Family Physician, Cape Winelands DistrictProf Marina Clarke: Stellenbosch University: Emeritus Professor of Nursing

@MatiesIPE#AMEE2013

Interprofessional Education and Practice (IPEP):

@MatiesIPE#AMEE2013

IPEP strategy took into consideration:4 ground-breaking publications:

• Frenk, J., Chen, L., Bhutta, Z.A., Cohen, J., Crisp, N., Evans, T., Fineberg, H., et al. 2010. Health Professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet, 376:1923-1958.

• Institute of Medicine. 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.

• Interprofessional Education Collaborative Expert Panel. 2011. Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.

• World Health Organisation. 2010. Framework for action on interprofessional and collaborative practice. Geneva: World Health Organisation.

Adapted with the permission of CanMEDS © 2005

In search of an Interprofessional Care/Collaboration Framework: a common language and approach

A statistical, research, clinical, social policy and educational tool to:

• Provide scientific basis

• Interprofessional teamwork

• Common language• Permit comparison• Systematic coding

scheme

2012: The ICF ride

• IPEP facilitators appointed to each site• Clinical case presentation (Ukwanda Rural

Clinical School)• Assessment: Students present to local

interprofessional team

The aim of this study

To establish how applying the ICF framework as IPE strategy contributed to 1. instructional reform2. institutional reform3. interprofessional

practice, and4. functioning of health

system

Design

• Associative group analysis • Questionnaires were administered to 70

participants: • 37 fourth year students, • 18 facilitators of learning • 15 patients.

• Free word associations were used to reconstruct the internal world and subjective meanings which were expressed by more direct methods.

Results: Students

Students indicated that they adopted a patient-centred interprofessional approach which improved patient outcomes and satisfaction.

Results: Health professionals

• Students’ response was confirmed• Were indirectly challenged to practice patient-

centred, interprofessional care as a result of them assessing students applying the ICF;

• Improved interprofessional collaboration and interprofessional practice;

• Bigger job satisfaction as they started applyingthe ICF in clinical practice.

Results: Patients

• Patients appreciated the improved quality of care.

Institutional reform: Interdependence• Appreciate for other

professions (incl. community care workers)

• Bottom up relationships: Commit to teamwork

• Harmonisation between education and health: Service providers request capacity building in ICF

Instructional reform: Transformative learning• Apply bio-psycho-

social-spiritual patient-centred care, questioning biomedical model in tertiary hospitals

• Integrate “clinical medicine” with “public health”

• Integrate ethics and human rights in patient care

Health system strengthening• Preceptors apply ICF in

teaching and practice • Adopt ICF as approach to

patient care in PHC and district hospital settings

• Influence patient outcomes

Discussion

ASSESSMENT DRIVES PRACTICE

The ICF ride continues…

Request by various sites/authorities for IPEP/ICF training Spontaneous change: clinical notes, discharge notesmICF mobile app project of WHO: Continuity of care - Community Care Worker Specialist

To make a long story short…

• Assessment of student presentations using the ICF framework drove interprofessional practice among healthcare students and professionals,

• Facilitated the bio-psycho-social-spiritual interprofessional approach to patient-centred care

• Resulted in improved patient outcomes• Strengthened health systems.

Acknowledgements

Global forum for innovation in health professions education

Publish or perish is OLD SCHOOL – Demo or die is NEW SCHOOLFake it or flunk is OUT – Engage and cherish is IN

WE NEED PARTNERS: JOINING IN?Dr Stefanus Snymanssnyman@sun.ac.za

@MatiesIPE