Presentation at the 2nd International Symposium: ICF Education. 30 June 2017 (Cape Town). http://www.icfeducation.org

1. Cape Winelands District
ICF Patient, Assessment and Referral / Discharge Form
2nd International ICF Symposium
2017
Rochelle Felix,
Magda Du Preez,
Jana Muller,
Handri Liebenberg,
Stefanus Snyman

2. © Western Cape Government 2012 |
Geographic Setting
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Why the ICF?
2012: University of Stellenbosch:
• Dr Stefanus Snyman manager of the
Interprofessional Education strategy
• ICF was part of this strategy from 1st
year to 6th year every year.
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Bringing ICF to Rural

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The development of a working tool
4
2012
•SU students
evaluation form
uses ICF
•Holistic and
patient centred
approach
•Interprofessional
ICF workshops for
CWDH
•Audit of therapists
notes completed
for CWDH and
research
2014
•Collaboration on
improving form to
improve patient
care and
documentations
2015
•SU rehab students
trials first draft –
give feedback
2016
•Finalisation of tool
after CWDH
therapist input
•Dr Crouse Circular
and CWD Circular
•SU review tool and
more align
specifically to ICF

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SHORT TERM
SHORT TERM
ACTIVITIES
Limitations in bed: rol, bridging
/ sitting/
standing/ walking
Eat /drink /toilet
Balance
Active movements UL/LL
BODY FX
Mental: unconscious / orientated/
IQ
Sleep/attention/memory
Sens: hear/ speak (expressive,
receptive) proprioceptive /
agnosia
Neuromuscular: power in UL, LL
Contractions, tone, atrophy,
abnormalities,…’
Respiration
Hart
Medical/surgical Hx
PARTICIPATION
Learning, applying knowledge
Performing task/demands
Mobility
Selfcare: wash/dressing/eating/toilet
Communication: verbal/non verbal
Interpersonal:family/strangers/basic/
Complex
Major life: education / work / payments/
bying food…
Social life:religion /leisure/ comm parti-
cipation
ENVIRONMENTAL
Barriers: steps / toilet outside / space for
wh chair / family support or not /
Attitudes of family / comm
PERSONAL
Attitude towards disease / Age / sex / Race /
Level of education /formal training work /
Pre mobid personality:jovial.socialily/ apathetic/
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Robertson Hospital 2012 simplification of the framework

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2012
•SU students
evaluation form
uses ICF
•ICF workshops for
CWDH
•Audit of therapists
patient folders
2014
•Research
study
completed-
impact of
rehab of Fx
outcomes and
organisational
impact
•Political will
2015
•SU rehab students
trials first draft – give
feedback
2016
•Finalisation of tool
after CWDH
therapist input
•Dr Crouse Circular
and CWD Circular
•SU review tool and
more align
specifically to ICF

7. © Western Cape Government 2012 |
FROM HEALTH SERVICE DELIVERY TO PATIENT-CENTRED CARE
The VALUE of the ICF for DoH:
Embraces the four elements Health Care 2030 :Packages the
domains of functioning and patient wellness
1. Patient centred approach
2. Common language and accountability to Provide
Integrated care
3. Continuity of care
4. A life-course perspective
OUTCOME: reciprocal learning between students and
therapists
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Integrated provision of carePerson centred approach
Life course perspectiveContinuity of care
Care from a patient not an organizational
perspective
Patients managed holistically,
treated with dignity & respect
Listening to patients
Empowering patients to make informed
choices
Increased compliance, improved quality of
care and better health outcomes
Multidisciplinary teams develop
care pathways
Include existing guidelines and
protocols
All stakeholders work with a single
assessment & care planning
process.
Deliver patient’s desired outcomes
through
seamless, consistent care through
the care pathway.
Effective discharge planning &
empowering patients for self-care to
reduce re-admissions & ALOS.
Transfer of comprehensive medical
records to ensure continuum of care.
A relationship with the patient that
considers past history as well as
future service.
Meeting patient needs from
antenatal to neonatal to childhood
to adolescence to adulthood and
to elderly stages of life.

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Process/development 2014-2017
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2015
Trail: SU rehab
students first draft –
gave feedback
•Collaborative
development
•Trial: Therapists
Rural Health
CWDH – gave
feedback

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2016
•Input and
finalisation of
tool
•Tool
adjustment
• Outcome
measure
included
•Endorsed by
RHDS

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FEEDBACK from WCRC
“If you cant measure it, it doesn’t exist”
LANDRUM OUTCOMES TOOL
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2017 Introduction
Working document
With a GUIDELINE on
Completing the form
based on ICF domains
Page 1
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Page 2
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The way forward
1. Get feedback from clinicians
2. Auditing of patient notes to understand the way
clinicians are using them
3. Tailor training and insight in practical use of the ICF
With the vision of creating a comprehensive ICF form without
the need for a guideline document, under the guidance of
Dr Stefaans Snyman
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Further development of the form in conjunction with Stellenbosch University

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Key ingredients to the process
This is an evolutionary process and changes will still be made
Every phase was a collaboration, knowledge was shared, critic was taken and
adjustments made
• Circular and guideline to completing the ICF Patient Assessment and Referral /
Discharge Form
• Encouragement from:
Rural District Health Services Dr L. Phillips and Dr R. Crouse
University of Stellenbosch Interprofessional learning: Dr S. Snyman

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Thank you
For more information please contact
Rochelle Felix: Rochelle.felix@westerncape.gov.za
Magda du Preeze: magda.dupreez@westerncape.gov.za
Jana Muller janamuller@sun.ac.za
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