Page 98 - HA Convention 2015

Special Topics

ST6.1 Rehabilitation – Future Trend and Development 14:30 Theatre 2

Monday, 18 May International Perspectives and Principles of the Development of Rehabilitation Services
Gutenbrunner C
Department for Rehabilitation Medicine, Hannover Medical School, Germany

The Global Disability Action Plan 2014-2021 – “Better Health for All People with Disabilities” of the World health Organization
(WHO) urges countries to improve access to health services for all persons with disabilities, to strengthen rehabilitation
services for persons with disabilities and chronic health conditions, and to collect scientific data of disability and service
outcomes. Responding to the action plan, a systematic and coordinated approach is recommended by the International
Society of Physical and Rehabilitation Medicine (ISPRM) with other non-governmental organisations connected with WHO.
It should be based on international principles of service delivery, clinical guidelines and international standards on disability
and outcome reporting. The following steps should be taken:

Step 1: Data collection and analysis on the need for rehabilitation services: To evaluate the need for rehabilitation
epidemiological data, data derived from disability surveys are important sources of information. Also data on healthcare
provision and systems are important. For prospective data collection, the ICF core sets are appropriate and feasible tools,
e.g. the generic set to implement in health systems; the disability core set for population with disabilities and the setting and
disease specific core sets for the evaluation of rehabilitation needs in subpopulations with specific health conditions.

Step 2: Developing a model for rehabilitation services and plan for its implementation: The WHO principles should be applied
in the models of rehabilitation services implementation in health systems, e.g. clear goal setting to improve functioning;
the multi-professional approach and rehabilitation must be implemented along continuum of care (acute, post-acute
and long term services); community based approaches as well as accessible to all ages. Guidelines based on evidence
should be taken into account. The newly developed description and classification of rehabilitation services by the ISPRM
can be a useful tool to describe both the existing and projected services. Finally a model of service levels may be used to
conceptualise rehabilitation services in countries or regions.

Step 3: Closing the gaps between the needs and existing services by building up or modifying services: This can be done
on a sound basis if the above mentioned database and models are available, however, several steps may need to be taken
immediately by using expert knowledge and experience.

Step 4: Implementing good practice models according to the analysis of needs and standards of evidence-based service
delivery.

Step 5: Quality management and evaluation of the implementation and outcomes of rehabilitation services: Besides the
general principles and tools of quality assurance, the above mentioned assessment tools may be used for quality control
especially with regard to health outcomes. Of course other assessment tools for outcome measurements may be used for
specific health conditions and services.

Expertise must be included in planning and implementation of rehabilitation services and capacity building of rehabilitation
professionals. To achieve this, international collaboration can be a good way to meet the goals within an appropriate period
of time.

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