Introduction: In light of global mandates and in recognition of the value of data collection and reporting based on the International Classification of Functioning, Disability and Health (ICF), the UEMS PRM Section and Board established an action plan to implement the ICF in Physical and Rehabilitation Medicine, rehabilitation and health care at large. This includes, among other steps, the development of a framework of rehabilitation service types for Europe (European Framework) and corresponding clinical assessment schedules (CLASs) for each service type. A CLAS encompasses the recommendation for what aspects of functioning to document, for whom and when, and the data collection tools to use. The objective of this paper is to report on the development of the CLASs for the European Framework developed in Stockholm in 2018, with focus on what to document.
Methods: Involving UEMS PRM delegates across European regions, a multistage Delphi process comprised the development of an initial proposal of the CLASs (i.e. default and optional ICF Sets to document), two feedback (pre- and post-Stockholm) rounds via e-mail, and a deliberation by the UEMS PRM during its March 2019 meeting in Budapest. In both Delphi rounds, participants were asked whether the initially proposed default and optional ICF Sets represent what is currently documented at an exemplary service provider in the country or in consideration of their own expertise. The European Framework was revised between the two Delphi rounds, requiring a revision of the CLAS proposal accordingly. Participants were additionally asked whether they support the suggested ICF Sets as the specification of the CLAS. Level of support (strong = ≥80%, moderate = between 80-60%, weak =≤59%) was calculated as the percentage of countries supporting the suggested CLAS over the number of responding countries. The results of the post-Stockholm round were presented for discussion, revision and approval at the Budapest meeting.
Results: Pre-Stockholm Delphi round: due to low response rate only a summary of comments made by the responding countries was provided as reference information for the post-Stockholm round. Post-Stockholm Delphi round: results indicated moderate to strong support for the proposed CLASs. Deliberation Budapest Meeting - Motions for specific revisions to the CLASs based on the results of the Post-Stockholm round were predominately accepted. With additional minor revisions, the UEMS PRM General Assembly approved a version of the CLASs for the European Framework.
Conclusions: To kick-off the implementation of these CLASs, UEMS PRM plans demonstration projects in at least one rehabilitation facility in each delegate country that exemplifies the rehabilitation service types of the European Framework which exist in the respective country. The demonstration projects are intended to orient service providers and clinicians to the CLASs and illustrate how the CLASs can be implemented.