ICF: turning concepts into practice
The Italian experience
Andrea Martinuzzi, M.D., Ph.D.
“E. Medea” Scientific Institute, Conegliano Research Centre
Research Branch of the WHO-FIC Collaborating Centre, Italy
Disability Italian Network
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Disability is a major public health issue
1.
567 Million healthy life years lost per year
2.
The poorest countries in the world share the highest
disability burden
3.
Information paradox: The least information for countries
with greatest need
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
UN convention
• Preamble e): Recognizing that disability is an evolving
concept and that disability results from the interaction
between persons with impairments and attitudinal and
environmental barriers that hinders their full and
effective participation in society on an equal basis with
others,
Art :1Persons with disabilities include those who have longterm physical, mental, intellectual or sensory impairments
which in interaction with various barriers may hinder their full
and effective participation in society on an equal basis with
others
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
• Art 25: States Parties recognize that persons with disabilities have the right to
the enjoyment of the highest attainable standard of health without
discrimination on the basis of disability. States Parties shall take all appropriate
measures to ensure access for persons with disabilities to health services that are
gender-sensitive, including health-related rehabilitation.
• Art 26: States Parties shall take effective and appropriate measures, including
through peer support, to enable persons with disabilities to attain and maintain
maximum independence, full physical, mental, social and vocational ability, and
full inclusion and participation in all aspects of life. To that end, States Parties
shall organize, strengthen and extend comprehensive habilitation and
rehabilitation services and programmes, particularly in the areas of health,
employment, education and social services, in such a way that these services
and programmes:
– Begin at the earliest possible stage, and are based on the multidisciplinary
assessment of individual needs and strengths;
– Support participation and inclusion in the community and all aspects of society, are
voluntary, and are available to persons with disabilities as close as possible to their
own communities, including in rural areas.
• Art 27: States Parties recognize the right of persons with disabilities to work,
on an equal basis with others; this includes the right to the opportunity to gain a
living by work freely chosen or accepted in a labour market and work
environment that is open, inclusive and accessible to persons with disabilities
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
ICF in Health and Disability Statistics
Impairment approach
•
•
•
•
Prototypical groups
Not indicator of need
Underreporting
Categorical
A&P / EF approach
•
•
•
•
Universal model
Indicator of need
Real life experience reported
Continuum
– Allows multiple threshold levels
– Multiple dimensions
• person - environment
• capacity – performance
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
ICF in Linking Health & Disability Surveys
Health Surveys
Disability Surveys
Health condition
Cause of disability
Level of functioning
Type of disability
Severity of disability
Interventions
Assistance required
Facilitators / barriers
Risk factors
Modulating factors
Prognosis
Impact of disability
Satisfaction
Satisfaction
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Issues in health, education, social and labour
policies for the persons with disabilities
• Provide a description of the functional profile across all ages
– neutral
– inclusive
– Not disease-selective but disease-sensitive
• Define the habilitation/re-habilitation project and structure the
program
– Multiprofessional
– Comprehensive
– Personalized
• Set the framework for outcome measurement
• Provide a reference for defining needs and plan resource allocation
• Guarantee the continuity of care across development milestones
and settings and across Services and Agencies
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Areas of ICF use
• Public Health
– Epidemiology
– Health statistics
– Policy planning
• Clinic
–
–
–
–
Phenotype description
Habilitation/rehabilitation planning
Effectiveness assessment
Outcome definition
• Education
– Identification of problems in school setting
– Functional profile
– Planning for special need education
• Rights implementation
– Allocation of benefits
– Labour policies
– empowerment
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Applications
1. (2005): ICF-CY as descriptor of functioning of
children with complex or rare disabilites
2. (2005/2006): ICF as a tool in Clinical
rehabilitation setting
3. (2006/2007): ICF as outcome descriptor
4. (2006/2007): ICF as a Roadmap
for the Rehabilitation project
5. (2004/2007): ICF as a tool to functionally profile
– Chidren with special education needs
– Persons with disability looking for job
6. (2007/--): ICF as descriptor of disability at the
Regional Level
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Clinical Applications
1) Phenotype descriptor and linkage with
established validated assessment tools
2) Test compatibility of ICF use within the clinical
setting of rehabilitation
3) ICF as a tool for priority setting in rehabilitation
4) Use ICF as descriptor of outcome
5) ICF as framework for rehabilitation project and
program
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Setting
• IRCCS “Medea”-La Nostra Famiglia
• Region of Veneto, North-East Italy
– Tertiary care Rehabilitation Hospital
• 40 bed Unit for severe childhood disability
• 40 bed Unit for Acquired Brain Injuries in adults
• 1000 patients/year
– Primary care Rehabilitation Center
• 250 children/day
• 2500 outpatients/year
• Multiprofessional team
–
–
–
–
Physicians and Nurses
Rehab technicians (Psychologists, PT, ST, OT, NPM)
Educators and pedagogists
Social workers
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Clinical use
• Obtain a complete, accurate and dynamic description of the
person functioning which is understandable to all partners
• realize the effective and appropriate medical intervention
proportionally to the needs
• organize the multiprofessional team to plan tailored
rehabilitation interventions
• focus on interdisciplinary exchange of information in every day
work, integrating different perspectives
• constantly offer counseling to the patient, the family, the
professionals
• Verify the results and re-adapt the rehabilitation and
educational program according to the functional status and the
developmental stage
• Plan in advance according to the needs of full participation in a
long term perspective
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
ICF useability
and linkage to assessment tools
Methods:
40 patients:25 males,15
females
age: 3-18 years
(10.705.28)
Main diagnosis:
7 motor disability (C.P.)
20 cognitive disability
13 multiple disability
(cognitive  motor
 sensorial)
Coding by ICF checklist:
• raters:physician,
psychologist, speech
therapist, physiotherapist,
social worker
• Sources of information:
direct observation, written
records, health-related
professionals and teachers.
Assessment by WISC-R o
WAIS-R, GMFM, FIM:
• raters: psychologist,
physiotherapist other than
ICF raters
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
CORRELATIONS AND RESULTS
ICF Domains
R (p)
ICF d1: Learning and
applying knowledge
-0.71 (0.0001)
Verbal IQ
-0.83 (0.0001)
GMFM
-0.82 (0.0001)
FIM:
communication
ICF d4: Mobility
-0.87 (0.0001)
FIM:
locomotion
ICF d5: Self Care
-0.89 (0.0001)
FIM self-care
ICF d4: Mobility
ICF d3:
Communication
ICF d7: Interpersonal
interactions and
relationships
-0.80 (0.0001)
Scales
FIM:
Relathionships
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
2 (2005): ICF-CY as descriptor of
functioning of children with complex
and/or rare disabilites
Pilot study on neurocognitive rehabilitation in
long-term survivors of childhood brain tumors
Department of Pediatrics, University of Padova
Medea Scientific Institute, Conegliano Research Centre
Fondazione Città della Speranza
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Materials & Methods
•multiprofessional evaluation at admission
•Translation into ICF-CY codes by experienced users
•Development of a profile counting open codes and
weighting assigned qualifiers
Patients
sex
8 F, 8M
Age at diagnosis
M 6a4m (range 2a5m-15a)
Age at evaluation
M 9a7m (range 4a11m-16a)
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
FUNZIONI CORPOREE
0,5
FUNZIONI MENTALI
0,47
1,2
0,45
1
qualificatore
ori
0,35
0,31
qualificatore
ori
0,4
0,3
0,25
0,2
0,15
1
0,31 0,75
0,8
0,6
0,5
0,4
0,31
0,31
0,31
psicomot.
emotivo
percett.
0,31
0,31
cogn. sup.
ling.
0,2
0,1
0,05
0
0
attenz.
F. MENTALI
F- SENSORIALI
memoria
cogn. base
COMUNICAZIONE
FATTORI AMBIENTALI
ATTIVITA' e PARTECIPAZIONE
2,00
2,5
2
qualificatori
qualificatori
0,44
1,5
1
1,50
1,00
0,50
0,5
0,00
0
apprend.
richieste gen.
comunic.
cura di sé
vita dom.
relazioni
istruzione
vita sociale
e1 prodotti e tecn.
performance capacity
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
e3 sostegno ambient.
facilitatori barriere
e4 atteggiamenti
prass.
Similar experiences for:
•
•
•
•
•
•
•
CP ages 0-18
Severe TBI
Spinal injuries
Rett Syndrome
Alternating Hemiplegia
Children with intractable epilepsy
Hereditary Spastic Paraplegia
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Conclusions
• ICF effectively describes the functional profile in
children, adolescents and adults
• Can provide a unifying vision of disability across
diagnostic classes
• Can provide the basis for identification needs and
targeted intervention
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
3 (2005/2006):
ICF as a tool in Clinical
rehabilitation setting,
• ICF can be introduced in the process of inhospital evaluation and treatment of persons with
disabilites?
– ICF use in such setting
• Who,
• when
• how
– Which are the needed steps to allow appropriate ICF
use
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Methods
• Training session for participants
– 1+3 days formal and practical training
• Identification of target population
– Children admitted for in-hospital rehabilitation
– Children followed for long term rehab programs
• Timing of coding
– After initial evaluation at admission
– At dimission
– At relevant transitions (pre-school/primary school, Center based
program/community based program)
• Protocol of application
– Multiprofessional coding
•
•
•
•
•
Physician: s1-8, b2, b4-6, b8
Psychologist: b1, d1
PT, ST, OT: b3, b7, d2-8
Pedagogist: d1, d8
SW: d9, e1-5
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
First encounter:
Physician:
Identification of
Problems and
Treatment requests
Extended
Multiprofessional
Evaluation Protocol
Medical tests
Special visits
Strumental tests
biohumoral tests
Neuropsychology
Cognitive functioning
Kinesiology
motor abilities
Social worker
Assessment of
Immediate and
related environment
Occupational
Therapy
ADL evaluation
ICF Checklist
or ICF-CY
Questionnaire
Discharge
Speech therapy
Communication
Treatment
Project
Verification
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Education
Learning and
related issues
Feedback after 6 months pilot trial
• Provides a common
language for all equipe
members
• Useful synthetic and
comprehensive descriptor
of patient needs
• Well applicable in all
medical conditions
• Time consuming
• Not clearly linked to
commonly used
assessment tools
• Not integrated in the
program setting
• Not integrated in a
systemic use within the
service network
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
4 (2006): From the ICF profile
to the Rehabilitation Project
Impairments
A.V. C7 ASIA-A at 10 m:
identified priorities
– Exploit the cognitive
potential (b1, d1)> Edu
– Improve
communication/interaction
(d3)> SpTh
– Prevent urinary infection
(b6)>Ab + periodic lab
– Optimize wheelchair
autonomy (d4)> PT, OT
– Prevent limb/trunk
deformities (b7, s7)>PT
Impairments
b7 muscles
s8 Skin
b6 GenitoUrinary
s7 Bone/Muscles
Functions2
Functions1
Structures2
Structures1
b2 Sens.
s6 GenitoUrinary
b1 Mental
s1 Nervous System
0
0,5
1
1,5
2
2,5
3
3,5
4
4,5
0
0,5
1
1,5
2
2,5
3
Limitations and Restrictions
3,5
3
2,5
2
A&P Performance1
A&P Performance2
A&P Capacity1
A&P Capacity2
1,5
1
0,5
0
d5 Self
CareLa Nostra
d4 Mobility
d3
I.R.C.C.S. "E. Medea"
- Ass.
Famiglia Polo Veneto
Communication
d2 General Tasks
d1 Learning
3,5
4
4,5
The context as determinant modulator
and as target of intervention
• Products & Technology
Barriers/Facilitators
– Drugs
– Catheter
– Orthesis
e1 Products & Technology
• Support & Relation
– Immediate & extended Family
– Professionals
e3 Support
Barriers1
• Attitudes
Barriers2
Facilitators1
– Immediate & extended Family
– Professionals
Facilitators2
e4 Attitudes
• Services, Systems & Policies
– Health & educational services
e5 Services/Policy
-4
-3
-2
-1
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
0
1
2
3
4
5
5(2007): ICF
to track changes in functioning
16 survivors of primary brain neoplasms treated
in a rehabilitation setting: 1 year follow up
FUNZIONI MENTALI
1,2
BF
qualificatori
-Deterioration of
attention and
memory
1
0,8
PRE
0,6
POST
0,4
0,2
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
s.
pr
as
g.
lin
up
.
gn
co
gn
co
.s
e
.b
as
tt.
rce
pe
ivo
em
ot
ot.
ps
ico
m
or
ia
me
m
en
att
-Improvement of
emotional functions
z.
0
Improvement of
performance in all
domains
2,5
2
qualificator
Improvement of
capacity in some
domains
FOLLOW UP A&P
1,5
1
0,5
Widened
performance/capacity
gap
0
apprend.
richieste gen.
comunic.
performance pre
cura di sé
capacity pre
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
vita dom.
relazioni
performance post
istruzione
vita sociale
capacity post
Reduction or removal of barriers
Optimization of facilitators
FOLLOW UP ENVIROMENTAL
4
3,5
qualificator
3
2,5
2
1,5
1
0,5
0
e1 prodotti e tecn.
facilitatori pre
e3 sostegno ambient.
barriere pre
facilitatori post
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
e4 atteggiamenti
barriere post
Request
Definition of areas
to be assessed
Multiprofessional
Assessments
RP
Procedure
Definition of medical
& functional diagnosis
MD
Rehabilitation Program
Equipe
Verification of
goals
Program
Update
Discharge
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Definition of the
Rehabilitation
Project
MD
Ministero del Lavoro e
delle Politiche Sociali
OMS
Organizzazione Mondiale della Sanità
Progetto “ICF in Italia”
Welfare Policy Development
Strategia di sviluppo, formazione ed utilizzo della
Classificazione Internazionale del Funzionamento, della Disabilità e della Salute
dell’Organizzazione Mondiale della Sanità
ICF e Politiche del lavoro
Progetto Pilota 2003-2005
Il
ITALIAlavoro
DIN - Disability Italian Network
Cultural and legislative evolution
Legge 382/68 COLLOCAMENTO OBBLIGATORIO
(mandatory employment)
Legge 68/99 COLLOCAMENTO MIRATO
(Targeted employment)
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
La legge 68/99 e il collocamento mirato
Basic Principles
Introduction of the concept of targeted employment
Balanced ripartition for the productive system
of the law requirements
APPLICATION OF THE TOOLS PROVIDED BY THE CONVENTION
BENEFIT ASSIGNEMENTS PROPORTIONALLY TO
THE DISABILITY SEVERITY OF THE WORKER
DEFINITION OF AD HOC NATINAL AND REGIONAL BUDGETS
FOR THE LAUNCH OF PROGRAMS AIMED AT
THE TARGETED EMPLOYMENT
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The definition of targeted employment
Disability is not the only factor taken in account
For “targeted employment” of persons with disability it is meant, according to
the point 2 of the L. 68/99
“the complex of technical tools and support that will allow an appropriate
evaluation of the persons with disability in their job capacity and their
placement in an adequate job setting, through the analysis of the type of
jobs, the forms of support, the positive actions and problem solving
connected to the environment, the instruments, the interpersonal
relations in the everyday work and relation milieu.”
INTERPERSONAL RELATIONS
WORKER
ENVIRONMENT
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
INSTRUMENTS
The personalized projects
The right job for the right person………
The new concept introduced by the law 68/99 requires the
structuration and use of a set of tools to achieve the
encounter between individual competences of the person
with disability and the characteristics of the work place, in
order to define the personalized project.
That means the contribution of a multiplicity of techincal
subjects (offices for the employment, medical cmmissions,
each with is own competence.
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
“PERSONALIZED projects”
Need for
effective tools (to better describe the person with
disability and the work place)
A functional network of all the involved actors
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
The network – on the “offer” side
ORIENTEREEING
INFORMATION
FIRTS ENCOUNTER
PERSON
with
DISABILITY
ENROLLMENT
SPI
ORDERED LIST
D/O MATCH
EMPLOYMENT
ANAGRAFICAL AND
PROFESSIONAL
PROFILE
Medical
Commission
ASL
MEDICAL
EVALUATION
MEDICAL REPORT
INDIVIDUAL
WORKER
FORM
(art.8 comma 1
Legge 68/99)
TECHNICAL
COMMETTEE
INFORMATIC
SYSTEM
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EVALUTAZIONE OF THE
RESIDUAL CAPACITY
PROPOSALS,
ADAPTATION
PROJECTS
THE NETWORK – “domand” side
TERRITORIAL
BALANCING
TEMPORARY
WAIVER
PARTIAL WAIVER
LIST
OF THE OPENINGS
INFORMATIVE FORM
EMPLOYER
SPI
PRESELECTION
EMPLOYER
JOB APPLICATION
PUNTO IMPRESE
WITH
dedicated i
information point:
BENEFITS
WORK PLACE ANALYS
BARRIERS,
ECC.
ON-SITE VISIT
WORKPLACE ANALYSIS
CHCKLIST
(ICF)
CHOICE OF THE
CANDIDATES
D/O MATCH
START OF THE
EMPLOYMENT
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Progetto ICF E POLITICHE DEL LAVORO
Specific Objectves
•Establish a National Team of trainers
•Train the widest possible number of people
dealing with Lobour related policies
•Field trials at selected sites
•Diffuse nationally and Internationally the results
of the project
•Establish a virtual forum for exchange of
experiences and knowledge on ICF and its
application
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Progetto ICF E POLITICHE DEL LAVORO
Project
Partners
Ministry
of Welfare
DIN
ITALIA
LAVORO
Disability Italian
Network
Ministry of
Health
Ministry of
Education
Regional
Coordination
office
UPI
Italian Institute
of
Social Medicine
ANCI
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
FISH
FAND
Progetto ICF E POLITICHE DEL LAVORO
• Training courses (basic and advanced)
completed in 3+25 sites in 5 regions (1000
trainees)
• Experimental application in the 3 pilot
sites within the process of guided and
supported employment for people with
disability (L68/99)
• Definition of an ICF-based checklist
describing abilities and disabilities
relevant for a targeted job placement
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Progetto ICF E POLITICHE
DEL LAVORO
- EXPERIMENTAL
APPLICATION -
WORKER DOSSIER
DEDICATED
CHECK-LIST (DPCM
13.1.2000)
EMPLOYER
FORM
(Notice of openings)
FUNCTIONAL AND
PROFESSIONAL PROFILE
Anagraphical/Profession
al form (ex art 8 Lg
68/99)
Work place analysis form
(profile-mansion)
JOB
START
CHECK LIST
ON SITE OBSERVATION
Profile
correction
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- Ass. La Nostra
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DPCM 13.1.2000
Movement of the extremities/limbs function
Muovere e usare gambe e braccia
 assente
 media
 potenziale
 minima
 elevata
Afferrare/spostare oggetti pesanti con le mani
 assente
 media
 potenziale
 minima
 elevata
Servirsi delle mani per svariate operazioni che richiedano
precisione
 assente
 media
 potenziale
 minima
 elevata
Muovere o tenere fermi i piedi coscientemente (ad esempio:
la capacità di usare una pedaliera)
 assente
 media
 potenziale
 minima
 elevata
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
DPCM / ICF Conversion
Progetto ICF E POLITICHE
DEL LAVORO
- SPERIMENTAZIONE -
Moviment of the extremities/limbs function
Muovere e usare gambe e braccia
b710 Funzioni della mobilità dell’articolazione
b720 Funzioni della mobilità dell’osso
b730 Funzioni della forza muscolare
b735 Funzioni del tono muscolare
 assente
 media
 potenziale
 minima
 elevata
Afferrare/spostare oggetti pesanti con le mani
d440 Uso fine della mano
d4400 Raccogliere
d4401 Afferrare
d4402 Manipolare
d4403 Lasciare
d4301 Portare con le mani
d4305 Posare degli oggetti
 assente
 media
 potenziale
 minima
 elevata
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
DPCM / ICF Conversion
Moviment of the extremities/limbs function
Servirsi delle mani per svariate operazioni che
richiedano precisione
d440 Uso fine della mano
d445 Uso della mano e del braccio
 assente
 media
 potenziale
 minima
 elevata
Muovere o tenere fermi i piedi coscientemente (ad
esempio: la capacità di usare una pedaliera)
 assente
 media
 potenziale
 minima
 elevata
d4350 Spingere con gli arti inferiori
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Modificed Checklist
Breve lista di dimensioni A&P
d2. COMPITI E RICHIESTE GENERALI
d210 Intraprendere un compito singolo
d2102 Intraprendere un compito singolo autonomamente
d2103 Intraprendere un compito singolo in gruppo
d2108 Intraprendere compiti singoli, altro specificato
d220 Intraprendere compiti articolati
d2202 Intraprendere compiti articolati autonomamente
d2203 Intraprendere compiti articolati in gruppo
d2208 Intraprendere compiti articolati, altro specificato
d240 Gestire la tensione e altre richieste di tipo psicologico
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Qualificatore
di
performance
Qualificatore
di capacità
The check-list has been tested on representative
cases :
Physical (92)
Sensorial (22)
Psychiatric (34)
Mental (28)
TOTAL TESTED CHECK LISTS: 202
OF WHICH 26 on the same persons by the medical
commission and the employment services
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Progetto ICF E POLITICHE
DEL LAVORO
- SPERIMENTAZIONE -
problems
INTRA-EQUIPE INTEGRATION
ORGANIZATION OF THE EQUIPE WORK
ENROLLMENT OF WILLING PARTICIPANTS AMONG THE PERSONS
WITH DISABILITIES
OVERLAP WITH ROUTINE JOB
THE CHECKLIST FILLING IS TIME CONSUMING
LACK OF THE MEDICAL COMPONENT IN THE EQUIPES
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Progetto ICF E POLITICHE
DEL LAVORO
- SPERIMENTAZIONE -
POSITIVE POINTS
1.
2.
INVOLVEMENT OF ALL THE ACTORS
RESPECT OF TIMING
3.
CONSOLIDATION OF THE EQUIPE COHESION
4.
BETTER INTEGRATION AMONG INVOLVED SERVICES
5.
DEFINITION AND STRENGHTENING OF THE NETWORK
6.
UNIFYING CONCEPTUAL MODEL
7.
UNIFYING TOOL
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Progetto ICF E POLITICHE DEL
LAVORO
PROJECT PRODUCTS
FORMATION
TRAINING COURSE
TRAINING PLAN
TRAINING MATERIAL
TUTOR GUIDE
ON-LINE TRAINING
EXSPERIMENTAL
CHECK LIST “ICF E POLITICHE DEL LAVORO”
FORM DPCM 13.01.2000
SCHEDA INDIVIDUALE DEL LAVORATORE
SCHEDA ANALISI POSTO DI LAVORO/MANSIONE
PROFILO PROFESSIONALE “INTEGRATO”
SCHEDA OSSERVAZIONE IN SITUAZIONE
APPLICATION PROTOCOL
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Prospective potential use of ICF
bio-psycho-social model
Favours targeted
employment
dynamic concept of functioning and
disability
Multiprofessional, multisectorial
Universal Linguage
Favours network integration
Favours information
use and exchange
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Progetto ICF E POLITICHE DEL
LAVORO
PRODUCT DIFFUSION
WEB SITE www.italialavoro.it/icf
CASE VIGNETTES
PUBLICATIONS
PROTOCOLS
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
ICF-CY and education
for children with special needs
• Background:
– inclusion in education for children with special needs is regulated
by national legislation and applied through local agreements
defining protocols
• Objective
– Within the revision of the agreement regulating the way in which:
• children with disabilities are identified,
• Functional diagnosis is defined
• The personalized educational plan is built
• Partners
–
–
–
–
Health Services at the provincial level (Treviso)
School administration
Municipalities
Medea Scientific Institute (scientific advisor)
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Steering Committee:
ULSS, CSA, IRCCS
Training
Medical Workgroup
3 professionals+3 teachers for
each school order from 1 CTI
per ULSS:
42 individuals
Work Group (school
workers + monitor):
Elaboration of the chcklist
prototype
(ULSS + IRCCS)
Development of the
proposed new format of
Functional Diagnosis
Harmonization of
tools
Families Association
Workgroup
Integration of the family
driven elements
Pilot Testing in selected
sites
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
School driven
screening
Individualized
education plan
Identification
of difficulties
Coded with ICF
Functional
Diagnosis
ICF based
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Medical
evaluation
discharge
Conclusions
• ICF and ICF-CY can describe children and adult functioning in
various health conditions, providing useful insight into the
functional consequences of diseases
• ICF provides a common language shared by all health
professionals and understood by professionals in other services
(school, labour, social services) allowing more efficient
networking
• ICF can be incorporated in the clinical process of in-hospital acute
and post-acute intensive rehabilitation functioning as an effective
roadmap for intervention
• ICF can efficiently track changes and helps identifying
determinants of outcome
• ICF may thus guide service organization and complement ICD
data for epidemiologic and statistical purposes
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
Conference on Children Health, Disability and ICF-CY held
in Venice, Italy on 25-26 October 2007.
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
THE ITALIAN
WHO-FIC
COLLABORATIVE
CENTER
FVG-ARS
Research Branches:
IRCCS Medea, IRCCS
Besta, ISTAT
The 2007 Annual meeting of the WHO Network of Collaborating
Centres for the Family of International Classifications (WHOFIC2007)
was held in Trieste, Italy, 28 Oct-4 Nov.
The meeting was co-organized by the WHO Collaborating Centre for
the Family of International Classifications in Italy and the WHO
Measurements and Health Information Systems (MHI) Department.
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto
ICF:
AN EVOLVING TOOL
FOR EVOLUTION
I.R.C.C.S. "E. Medea" - Ass. La Nostra Famiglia Polo Veneto