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Sagahutu J.B.1,2, Kagwiza J.2, Cilliers F.1, Jelsma J.1
1University of Cape Town, Cape Town, South Africa, 2University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
Background: Good collaboration between Health Care Professionals can reduce medical errors, enhance the spread of critical information, and assist in interpretation of health information resulting in improved patient care. The International Classification of Functioning, Disability and Health (ICF) was found to be a potential framework to help health professionals provide a common language for better collaboration.
Purpose: To determine whether the use of the ICF as a framework to promote interprofessional behaviour among health professionals in Rwanda district hospitals results in improved holistic care, as evidenced by entries in patient records.
Methods: A Cluster Randomised Control Trial (CRCT) was used. Four district hospitals were randomly allocated to receive a days training in interprofessional practice using ICF (experimental) or a short talk and a booklet on the topic (control). The trainees were medical doctors, nurses, physiotherapists, social workers, nutritionists, and mental health nurses. Simple random sampling was used to assess patients records of discharged patients from medical, surgical and paediatric wards before training, two-month, four-month, and six-month in two experimental and two control hospitals. A validated self-designed checklist was used to audit patients folders. The independent t-test was used to establish if the two sets of groups were equivalent before and after training. Repeated measures ANOVA and post-hoc Tukey test was done to compare the scores at baseline, two-month, four-month, and six-month.
Results: A total of 1600 patients folders were examined (800 folders in experimental and 800 in control group: 200 at baseline, two-month, four-month, six-month in each group). At baseline, the mean number of items included was not significantly different between the two groups (p=0.424). At two months post-intervention, the difference between the two groups was highly significant (p .001). The items in which the greatest improvement was noted in the experimental group were related to interprofessional practice, followed by improved reporting on environmental factors, participation restriction and activity limitations. The post-hoc Turkey test indicated the significant difference at p .001 level for every post-intervention score at two, four and six months. The control group remained at the same level and there was no difference in their scores over time, however from the two-month assessment they were significantly lower than the experimental group.
Conclusion(s): The use of the ICF as a framework for training health professionals regarding interprofessional practice resulted in a significant improvement in behaviour as demonstrated by comprehensive patient records.
Implications: It is thus recommended that the framework can be used in interprofessional education and practice in Rwanda and other similar countries.
Funding acknowledgements: 1. Government of Rwanda for sponsoring the study.
2. Stefanus Snyman for assistance in the initial conception of the study.
2. Stefanus Snyman for assistance in the initial conception of the study.
Topic: Professional practice: other
Ethics approval: The Human Research Ethics Committee of the University of Cape Town and the Rwandan National Ethics Committee.
All authors, affiliations and abstracts have been published as submitted.
