Rehabilitation system in Ukraine: updates from August 21, 2015...Rehabilitation system in Ukraine:...

Rehabilitation system in Ukraine:

updates from August 21, 2015

Volodymyr Golyk, WHO UA Disability and Rehabilitation Sub-Cluster Coordinator,

Assoc. Prof. , MD, PhD,

Ukrainian State Institute of Medical and Social Problems of Disability

Ministry of Health of Ukraine,

Ukrainian Society for Neurorehabilitation, Board Chairman,

Neurologist

ACTION PLAN: 3W

1. Joining UEMS PRM Section and Board;

2. Establishing REHAB medical Specialties with EU based

professional competences;

3. PRE Legislation EDU and Organization Activities;

4. Education changes

5. Low for Rehabilitation in Ukraine

1. Joining UEMS PRM Section and Board;

2. Establishing REHAB medical Specialties with EU based

professional competences;

3. PRE Legislation EDU and Organization Activities;

4. Education changes

5. Low for Rehabilitation in Ukraine

The Committee for Education = the European Board of PRM

The Committee for Professional Practicedomain of competence of PRM Specialists

The Committee for Clinical Affairs

Quality of Care in PRM

Permanent Working Group of Balneology

September 05, 2015

The European Board of Physical and Rehabilitation Medicine

The main activities of the Board are:

Harmonization of PRM training in Europe

Certification of PRM specialists (by examination and equivalence)

Certification of PRM trainers

Certification/Recertification of PRM training centers

Continuing Medical Education and Recertification of PRM Specialists

Accreditation of European congresses and Teaching Programs

“Teaching” “Teachers”

SELECTION CRITERIA: chairing (deputy chairing) academic department with adequate clinical

environment (acute and subacute rehabilitation), possibility and capacity for introducing all gained practical and organizational

info into the clinical setting, possibility and capacity for teaching (reeducating) future UA PRM doctors.

35 UA PRM academic specialists

Selection of such persons will be made by general decision of Chairs Ukrainian Society of PRM and Ukrainian Society for

NeuroRehabilitation

Ukrainian Society of Physical and Rehab Medicine

2016

4 EU PRM academic experts

4*5 days PRM trainings

ISPRM Rehabilitation Advisory Team Involvement

WHO-ISPRM (UEMS PRM S&B) Collaboration Plan

Collaboration project #2:

Fast Response Teams on strategies and plans of rehabilitation

and related services.

Collaboration project #3:

ICF based routine data collection in national health information

systems.

WHO-ISPRM (UEMS PRM S&B) Collaboration Plan

Collaboration project #2:

Fast Response Teams on strategies and plans of rehabilitation and

related services.

Objectives:

To carry out consultations with countries on request aiming at

strengthening rehab services and building capacity of the rehab

workforce:

to provide matrix and checklists to analyze existing Rehab

services as well to identify gaps in service provision;

to establish Rehab Services Advisory Teams of experts with

global and regional health systems understanding that can

provide guidance for governments

WHO-ISPRM (UEMS PRM S&B) Collaboration Plan

Collaboration project #3:

ICF based routine data collection in national health information

systems.

Objectives:

Development and implementation of a National models for the

use of ICF in routine clinical practice;

Development and implementation of a National Rehabilitation

Quality Management Programs

ISPRM Rehabilitation Advisory Team Involvement

Fast Response Rehab Service Advisory Team

visit to Ukraine

is expected for the

first decade of December 2015

1. Joining UEMS PRM Section and Board;

2. Establishing REHAB medical Specialties with EU

based professional competences;

3. PRE Legislation EDU and Organization Activities;

4. Education changes

5. Low for Rehabilitation in Ukraine

hard discussion

NO consensus/decision

Agreement reached

MDs

Name: MD “Physical and Rehabilitation Medicine”

Professional competences – according to White Book of Physical and

Rehabilitation Medicine (majority of MDs and academic staff unaware)

Edu (re-Edu) – the same Chairs as for Physiotherapy MDs

adequate clinical environment (subacute-acute low functioning

rehab)!!!

Working places – acute/subacute/continuous rehab settings – NA

team for chairing - NA

Establishing REHAB medical Specialties with EU based

professional competences

Medical but not MD

Name:

“Physical therapists” (WCPT) vs “Physical Rehabilitologists” (UA)

NO “Non MD” Therapists in UA!!

Professional competences –World Confederation of Physical Therapy based

Edu (re-Edu) – non Medical vs Medical high schools (bachelor-magister) ????

adequate clinical environment (subacute-acute low functioning rehab)!!!

Working places – current legislation (1 per 250 beds) ????, What to do with

existing and still educating persons???

team for joining - NA

Establishing REHAB medical Specialties with EU based

professional competences

Medical but not MD

Name:

“Ergo (occupation) therapists” (WCOT) vs “Labor therapists” (UA)

Professional competences – both medical & pedagogical based

Edu – both Pedagogical and Medical high schools (bachelor-magister) ????

adequate clinical environment (subacute-acute low functioning rehab)!!!

Working places – absents

team for joining - NA

Establishing REHAB medical Specialties with EU based

professional competences

Medical but not MD

Name:

“Prosthetic and Orthotic” (ISPO) vs “Technicians Prosthetists” (UA)

Professional competences – both medical & technical based

Edu – ??? (bachelor-magister) ????

adequate clinical environment (integrating subacute-acute rehab services)!!!

Working places

team for joining - NA

Establishing REHAB medical Specialties with EU based

professional competences

1. Joining UEMS PRM Section and Board;

2. Establishing REHAB medical Specialties with EU based

professional competences;

3. PRE Legislation EDU and Organization Activities;

4. Education changes

5. Low for Rehabilitation in Ukraine

hard discussion

NO consensus/decision

Agreement reached

Mapping Disability and Rehab information

Pilot centers detecting and local rehab team building;

Partners edu activities for pilot centers and teams in clinical setting

PRE Legislation EDU

and Organization Activities

Mapping Disability and Rehab information

PRE Legislation EDU

and Organization Activities

Analytical –

informational

reference book

Annually more

than 37 years

Mapping Disability and Rehab information

PRE Legislation EDU

and Organization Activities

Disability = Invalidity Status (after examination and revealing certain

level of…)

ONLY primary examination results (not re-examination)

ONLY for some specific groups of disorders

NOT come – NOT served (no general medical digitalized records)

0

500

1000

1500

2000

Инвалиды ІА группа ІБ группа ІІ группа ІІІ группа %

2148 16 58 132

897

1613

27 43

363

1180

2 5132014 2015

Total number: 2014 – 1116 persons

2015 (9 months) – 4126 persons

Servicemen examinations (primary)

PRE Legislation EDU

and Organization Activities

Mapping Disability and Rehab information

PRE Legislation EDU

and Organization Activities

Mapping Disability and Rehab information

PRE Legislation EDU

and Organization Activities

Про затвердження Інструкції щодо заповнення форми звітності №14 "Звіт

про причини інвалідності, показання до медичної, професійної і

соціальної реабілітації за 20___ рік": Наказ МОЗ №378 від 10.07.2007

2015,V. Stebliuk, МoD

Pilot centers detecting and local rehab team building

PRE Legislation EDU

and Organization Activities

Partners edu activities for pilot centers and teams in clinical setting

PRE Legislation EDU

and Organization Activities

1. Joining UEMS PRM Section and Board;

2. Establishing REHAB medical Specialties with EU based

professional competences;

3. PRE Legislation EDU and Organization Activities;

4. Education changes

5. Low for Rehabilitation in Ukraine

hard discussion

NO consensus/decision

Agreement reached

MDs PRM Edu (re-Edu):

medical High Schools; NO current programs (exp. EU PRM S&B);

the same Chairs as for Physiotherapy MDs

adequate clinical environment (subacute-acute low functioning rehab)!!!

Non MDs PT/OT/P&O Edu (re-Edu):

General Edu Standard need !!!

Non Medical vs Medical?

adequate clinical environment (aver WCPT 1200 hours per min 4

years)!!

Education Changes

1. Joining UEMS PRM Section and Board;

2. Establishing REHAB medical Specialties with EU based

professional competences;

3. PRE Legislation EDU and Organization Activities;

4. Education changes

5. Low for Rehabilitation in Ukraine

hard discussion

NO consensus/decision

Agreement reached

1. Process starting since Dec 2014 (Parliam. Committee for

Veterans & Invalids)

2. Process continuing since May 2015 (Parliam. Committee for

Health Care)

Non MDs specialties names (definitions from UA Vocabularies vs

Intl Bodies);

ICF NOT included;

Goal setting principles NOT included

Person-Invalid AND Person with Disabilities

Low for Rehabilitation in Ukraine

vs