To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England

• Published in: Disability and rehabilitation 2012-10, Vol.34 (20), p.1686-1694
• Main Authors: Tempest, Stephanie, Harries, Priscilla, Kilbride, Cherry, De Souza, Lorraine
• Format: Article
• Language: English
• Subjects: Action research; Activities of Daily Living - classification; Classification; Disability Evaluation; Disabled Persons - classification; Disabled Persons - rehabilitation; England; Focus Groups; health; Health Plan Implementation; Humans; ICF; implementation; Interdisciplinary team work; International Classification of Diseases; Interprofessional Relations; Interviews as Topic; Learning; Patient Care Team - organization & administration; Professional Role; Research Paper; stroke; Stroke Rehabilitation; Strokes; Terminology; Vocabulary, Controlled
• ISSN: 0963-8288; 1464-5165
• DOI: 10.3109/09638288.2012.658489

Purpose: The success of the International Classification of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Method: Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and reflective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, field notes and a reflective diary. Results: Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. Conclusions: The empirical findings demonstrate how to make the ICF classification a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians. Implications for Rehabilitation The International Classification of Functioning, Disability and Health (ICF) is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the actions necessary to aid the implementation process, with clinicians, have not been explored. This study found that an acute stroke multidisciplinary team needed to adapt the ICF and own the way it was introduced within their team, to adopt it into practice.