European initiative for the application of the International Classification of Service Organzation in Health-related Rehabilitation (ICSO-R)

BACKGROUND: The International Classification of Functioning, Disability and Health (ICE) should be used as the framework for the development of a clinical assessment schedule for clinical quality management of health-related rehabilitation services. For the description of rehabilitation services a working group of the ISPRM-WHO-Liaison Committee proposed an instrument called "International Classification System for Service Organization in Health-related Rehabilitation" or ICSO-R. AIM: To test the applicability and feasibility of ICSO-R to describe rehabilitation services and to propose further improvements. DESIGN: A workshop was held. SETTING: SPF (Swiss Paraplegic Research) in-Notrivil, January 2016. POPULATION: Six working groups, composed of delegates front UEMS PRM (Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists) and experts from other rehabilitation professions. METHODS: Each working group selected an existing service of a predefined category (one acute, three post-acute and two long-term rehabilitation services). The instructions were: 1) make a narrative description of an exemplary service; 2) describe the exemplary service using the dimensions and categories of ICSO-R; 3) continent on feasibility of the ICSO-R table, on shortcomings, and make suggestions for improvement. The narrative and ICSO-R descriptions were analyzed and compared, and recommendations were made for modification of ICSO-R. RESULTS: The narratives were very' heterogeneous and none comparable. ICSO-R use was feasible and significantly increased precision and comparability of the descriptions of existing rehabilitation services. Proposals for improvement were made, for example the addition of lacking categories. Suggestions were made for clarification of a number of characteristics, including a taxonomy with value sets. CONCLUSIONS: The UEMS PRM workshop on the description of health-related rehabilitation services for use in a clinical quality management schedule clearly demonstrated feasibility and applicability of ICSO-R, showing more precise and comparable descriptions as compared to the narratives. However, in a next version some modifications should he made to improve clarity. CLINICAL REHABILITATION IMPACT: It is recommended to use ICSO-R to describe and compare existing as well as model rehabilitation services for benchmarking and implementation into health systems worldwide. The ISPRM-WHO Liaison committee working group will further modify and improve ICSO-R.