Poster presentation at the 2nd International Symposium: ICF Education. 30 June 2017 (Cape Town). THEME: ICF as catalyst for interprofessional education and collaborative practice http://www.icfeducation.org

1. Using ICF to describe functioning and KSI to
describe social care interventions in structured
digital documentation in social care
Almborg A-H1,2,3
, Berisson E1
, Bratt M1
1 Swedish National Board of Health and Welfare, Stockholm, Sweden; 2 Nordic WHO-FIC CC, Oslo, Norway; 3 The Jönköping Academy for impro-
vement of Health and Welfare, Jönköping University, Jönköping, Sweden
Abstract This poster describes how ICF and KSI can be used together in electronic social care records. The result shows that the frameworks and
common terminologies of these two classifications are useful, complement each other, support a need-orientated focus, and can be used in the electro-
nic social care record. To support the implementation of ICF and KSI e-learning materials are needed, the electronic records structure needs further
development, and decision makers at local level have to decide to commit to implementation.
www.socialstyrelsen.se
Introduction
In connection with the Swedish strategy for
eHealth, the National Board of Health and
Welfare (NBHW) is responsible for the deve-
lopment and management of the national in-
formation structure and the interdisciplinary
terminology for health and social care. The In-
ternational Classification of Functioning, Disa-
bility and Health (ICF) is currently used as a
common terminology to describe functioning
and disability in some areas of social care do-
cumentation such as the Individual’s Needs in
Focus (IBIC). The NBHW has also been com-
missioned by the government to develop the
Swedish national classification of social care
activities and interventions (KSI). KSI is based
on the International Classification of Health In-
terventions (ICHI).
Figure 1. The three axes in ICHI and KSI.
The KSI was published in January 2015 and in-
cluds 556 investigative activities, 516 suppor-
tive activities, 85 legal administrative activities
and 54 interventions for official statistics.
The aim of this poster is to describe how ICF
and KSI can be used together in the electronic
social care record to improve the quality and
comparability of data for:
• local documentation
• exchanging and sharing information
between different caregivers
• local monitoring
• national statistics
• development of evidence-based practice
Within social care, the classifications are used
by social care professionals, representatives of
the social care sector, business developers and
people responsible for social care development
and monitoring at national level.
Methods & Materials
To identify the use of ICF and KSI in practice
a process-model of social care and the regula-
tions of documentation in social care (SOSFS
2014:5) have been used. This work has been
done together with social care professionals.
To identify relevant ICF-categories a model of
needs assessment also was used. Field tests
have been conducted to evaluate the use of ICF
and KSI as frameworks and common termino-
logies to support practice and documentation
in electronic social care record. Using ICF and
KSI is also described in concept- and informa-
tionmodels.
Results
ICF is used to document the person’s social
care issues, to describe actual functioning, to
assist in goal-setting, to assess support needs. It
is also used in follow-up for assessing the actual
functioning and achievement of the goals. KSI
are used to describe social care activities and
interventions (decided, planned, performed/not
performed and finalized) (Figure 2). KSI com-
plements ICF describing which social care inter-
ventions and activities that have been planned
and performed during the investigation and as-
sessment, to support the person and for follow-
up (Figure 2 and 3).
Figure 2. Using ICF and KSI in social care
process
Intitate
Experienced
health
problem (ICF)
Investigate and
assess
Investigative
social care
activities (KSI)
Functioning
Goal-setting
Needs assessment (ICF)
Proposal of social
care supportive
activities (KSI)
Decide
Supportive
social care
activities (KSI)
Needs (ICF)
Design
assignment
Supportive
social care
activities (KSI)
Perform
assignment
Planned
supportive social
care activities
(KSI)
Functioning
Goal-setting
(ICF)
Performed
supportive social
care activities (KSI)
Follow-up
Follow-up social
care activities in
(KSI)
Functioning
Goal achivement
(ICF)
Finalized supportive
social care activities
(KSI)
Figure 3. Example of use of ICF and KSI
The results from the field tests show that the-
se two classifications are useful both for sup-
porting practice and for documenting practice
in electronic social care record. The professio-
nals reported that use of ICF facilitates use of
KSI. Field tests also show that using ICF and
KSI in social care contributes to a broader
mindset and way of working with the individual
needs-orientated focus.
Conclusions
ICF and KSI (based on ICHI) are two useful
classifications that provide common termino-
logies and frameworks to be used in practice
with a needs-orientated focus as well as in the
electronic social care record.
These classifications can also be used for
comparisons of data to support systematically
evaluation, evidence-based practice, national
statistics and for exchanging or sharing infor-
mation between different caregivers.
To support the implementation of ICF and KSI:
• E-learning materials are needed
• the electronic social care records must
be further developed
• decision makers at local level have to
commit to implementation of ICF and KSI
Implications – the NBHW supports the use of
ICF and KSI at national level for a range of
applications and also for use at local and
regional level in electronic social care
documentation.
Preparing meals Functioning – described/assessed
No Mild Moderate Serve Complete COMMENTS
Lisa can plan her breakfast, lunch
and dinner but have limitations in
organizing and cooking dinner
and making lunch
Goal- seƫng
Lisa wants to cook dinner and
make lunch
Assessed needs of
social care
Yes, but can be supported by others
Yes, can be supported by social care
Proposal of social care
acƟviƟes
Training in preparing meals
Performing the task of preparing meals
PracƟcal support with preparing meals
EmoƟonal support for preparing meals
Functioning
Goal-
setting
Assessed needs
of social care
Proposal of social
care activities
Investigate &
assess
Second International Symposium: ICF Education 2017
Ann-Helene Almborg
ann-helene.almborg@socialstyrelsen.se