Rehabilitation is a goal-directed process through patient-centered relationships with family rehabilitation providers and Community. Rehabilitation focuses on optimizing function and aims to promote independence and social integration. It includes prevention of injury/illness recurrence and/or secondary disease.
The Rehabilitation Framework provides guidance to support clinician managers and planners in improving access to quality sustainable rehabilitation services. These frameworks outline key elements of rehabilitation services and promote a common understanding of rehabilitation by: Provides a common language and definitions for concepts related to rehabilitation. This serves as a guide for planning management and providing a consistent and preferred approach to rehabilitation to meet patient and community needs.
There are a wide range of frameworks available to support rehabilitation services in different settings, including but not limited to competency frameworks, standards of nursing practice models, and integrated care pathways. A common recovery language is critical because people with Impaired functioning may interact with many professionals and systems, such as health education and social care. The recovery process is more efficient if all those involved base their approaches and communication on a common language and concepts. especially now Several health and human services and systems provide long-term services and support to the growing number of people affected by chronic conditions. A common language is essential to support integrated care to ensure person-centred care and is the foundation of the recovery framework.
The International Classification of Functioning and Health (ICF) introduced by the World Health Organization (WHO) in 2001 provides a common language to ensure a comprehensive understanding and description of ‘function’ and should provide a basis for all  It takes a patient-centered approach to biopsychosocial health and recognizes the many factors that affect health and optimal functioning. The model encourages rehabilitation providers to study how health conditions interact with environmental factors An individual’s internal and external influences on an individual’s day-to-day activities and social participation.  Adopting this model as the basis for a rehabilitation framework will support rehabilitation provider researchers and administrators in transforming their practice to focus more on Optimize functionality to provide guidance for planning and evaluating rehabilitation services. 
By using this common language, all disciplines in rehabilitation can better understand each other’s work and begin to develop commonalities across discipline-specific modes of thought that allow more scientific discourse to examine and determine the nature of function Either as a whole or its components. This allows for the investigation of links between its components, determinants of function and the effectiveness of interventions that may improve function. Therefore, the ICF should be a central pillar of rehabilitation theory, and Practice and support all of the recovery frameworks below. 
Rehabilitation in Health Framework
The Health Rehabilitation Framework (Figure 1) provides a general structure and organization of rehabilitation in healthcare that can be used to develop rehabilitation services to help inform systematic assessments of rehabilitation in specific contexts. Rehabilitation configurations vary significantly across countries, but the framework highlights common rehabilitation types and suggests an optimal rehabilitation mix for a country. It also highlights the different types of recovery and recovery settings Recovery occurs most often. Visualized through the adaptive pyramid structure commonly used to illustrate the organization of tertiary and primary health care, with community-provided rehabilitation and informal self-care as components basis of this model. 
Figure 1. Rehabilitation in the health framework 
Table 1 Types and Characteristics of Rehabilitation Types of Rehabilitation Characteristics User Groups Professional High Intensity Rehabilitation Professional rehabilitation has high intensity delivery capabilities in long-term facilities or programs. Usually for people with complex needs that affect Multiple functional areas. Consider tertiary care – possibly starting in the acute phase and continuing into the subacute phase. May be highly specialized for one health condition, such as spinal cord injury, or provide rehabilitation services for people with multiple health conditions in a specialized Rehabilitation Center. Rehabilitation interventions are delivered by rehabilitation personnel, but can also be provided by other professional health personnel. Spinal Cord Injury Traumatic Brain Injury Burn Stroke Major Trauma Orthopedic Fracture and Replacement Adaptation Pain Organ Transplant Amputation Cardiovascular Disease Neurological Disease Psychiatric Rehabilitation Integrative Medical specialties in tertiary and secondary healthcare are less specialized, often with short-term deliveries in acute or subacute care. integrated into health Services and programs for people with a variety of medical conditions treated in tertiary and secondary health care. Rehabilitation interventions are most often delivered by rehabilitation personnel, but can also be provided by other health care providers personal.MusculoskeletalNeurologicalCardiovascularRespiratoryGeriatricPsychiatricInternalOrganHearingVisionGynaecologicalPaediatricRehabilitation Integrated intoPrimaryHealthCare Provided in the context of primary health care, which includes services and professionals as the number one Touchpoints enter the health system. It may be provided in acute subacute and long-term care phases. Rehabilitation interventions are most often provided by rehabilitation personnel, but can also be provided by other primary health care personal.MusculoskeletalNeurologicalCardiovascularRespiratoryPediatricPsychiatricCommunity-DeliveredRehabilitationDistinguished through its delivery in community settings.Terified secondary and primary care can all delivered in a community setting A form of secondary care that occurs in subacute and long-term care. It is given intermittently (sporadic) for short periods of time or at moderate to low intensity for long periods of time. Delivered through a range of mechanisms, examples include outreaching rehabilitation personnel to homeschools or Workplaces; routine mobile clinics where rehabilitation personnel deliver interventions such as assistive products. May also be incorporated into other health and social programs such as home care; early childhood intervention programs; and disability-centred communities Serve. Rehabilitation interventions are most often delivered by rehabilitation personnel, but can also be delivered by other health personnel. Rationalize further optimization of functioning for those who give birth in these settings, as well as for those who have difficulty recovering in external settings these settings. Recently discharged from specialized high-intensity services; intermittent rehabilitation needs and limited transportation; children with developmental difficulties and disabilities; older adults receiving specialized health programs; deteriorating vision condition Illness; Mental Illness Rehabilitation needs in long-term care facilities Informal and self-directed care This is not a rehabilitation service, but part of informal and self-directed care that occurs in situations where rehabilitation or health personnel may not be present. Occurs during recovery or as It can also occur when people begin their own rehabilitation as part of an individual rehabilitation program to maintain or further improve their function in the long-term. Examples of this include caregivers supporting recovery in long-term care settings; educators Rehabilitation for children with disabilities in schools; yoga or tai chi classes for those with low back pain; peer support group activities and coaches to incorporate rehabilitation into athletic training programs. It also includes the People maintain or improve their functions at home. This includes anyone who initiates activities to maintain or further improve their functioning.
Competency in professional competence is “the behavioral definition of the intellectual skill values and personal qualities that underlie the adequate performance of professional activity” , and is a dynamic process that requires healthcare professionals “to keep pace with time” advance” change’ to maintain and continuously develop capabilities . Competencies should be associated with measurable, durable and trainable behaviors that facilitate the performance of an activity, which indicate whether a person is competent or able to perform the activity as prescribed standard. Activities are time-limited sets of trainable and measurable tasks that leverage knowledge skills values and attitudes . Additionally, competency is the ability of a healthcare professional to practice safely and effectively in a variety of different levels of context and situations. complex. A person’s level of competence in any situation will be influenced by many factors including but not limited to their qualifications, clinical experience, professional development and ability to integrate knowledge skills, attitudes, values and judgment. .
A competency framework is a structure that lists and defines each individual competency or personal attribute (such as problem solving or people management) required of an individual working in an organization or part of an organization. This is an efficient model that broadly describes performance excellence. Such a framework typically includes a number of competencies applicable to multiple roles within an organization, each defining superior work behaviors in generic terms. A competency framework is a means by which an organization can communicate which behaviors Need to be valued and rewarded in specific career roles. It ensures a shared understanding of the organization’s values and expected high-performance behaviors.
Competency frameworks are used in a wide range of systems around the world (for example, health systems education systems business) and serve a range of purposes. Historically, in healthcare, they have emerged with two distinct goals, each with specific characteristics: Supporting development competencies (often the primary focus of the education sector in training healthcare professionals) and help define performance standards (often the primary focus of healthcare systems guiding workplace performance expectations). Although in practice many abilities The framework achieves a mixture of the two goals above, with key characteristics that depend on the environment in which the capability framework is used. Below we look at the main characteristics of the competency framework in the main applications in use today (Table 2).
Table 2. Examples of applications of the Rehabilitation Competency Framework and their corresponding features  Key features of the application of the Competency Framework to support rehabilitation education and training, such as instructional curriculum development. educational institution use A competency framework that articulates course outcomes. They can be used to shape the learning outcomes of courses and ensure that the knowledge and skills taught by institutions match the needs of the population. Focus on the competencies and behaviors learners should possess Develop but also consider the activities and tasks they may need to perform Often include different levels of proficiency or milestones that should be reached at different stages of education and training or professional development Define the knowledge and skills that underpin competencies and competencies Behavior • Proactive or aspirational in performance expectations Supports professional regulatory certification or rehabilitation licensure. Competency frameworks are used by regulatory or accreditation bodies to communicate industry expected standards. when applied to Pre- and post-employment education, and implemented through audits and other mechanisms, form an integral part of the quality assurance process. Focus on the activities and tasks that rehabilitation workers should be able to perform, but also consider their abilities and behaviors Enables rehabilitation workers to effectively perform at a single proficiency level commonly defined to be considered competent • Capturing existing or current performance expectations supports performance evaluation of the rehabilitation workforce. in the context of human resources The management competency framework defines high performance and provides a benchmark against which to evaluate workers. They are also integral to establishing personal and service-wide developmental priorities. Include competencies and activities with clear performance indicators (example How these will be demonstrated in specific real-life scenarios) may include different levels of proficiency that capture where a person’s performance falls on a continuum, or a defined level of proficiency where a person is considered competent or incompetent usually includes performance Indicators relevant to the environment demonstrating capacity and activity capture existing or current performance expectations to support workforce assessment and planning by the Ministry of Health and specific health services. In the context of planning, they enable services to Successfully align workforce capabilities and activities with population needs and service objectives and help identify knowledge and skills gaps and performance deficits. The Ministry of Health can apply the competency framework to workforce assessment and planning, e.g. capacity Gap Analysis.
In the healthcare system, the majority of the workforce is initially guided by a competency framework developed through their specific professional body, which focuses on discipline-specific competencies. But recently the World Health Organization has recognized the need A competency framework that can be ‘adopted and adapted’ by any rehabilitation professional body or profession, and developed for any setting. Below we examine these competency frameworks in more detail.
Professional Organisation Competency
There are many core specialties that provide rehabilitation services, including but not limited to: Audiology, Occupational Therapy, Physical and Rehabilitation Medicine, Physical Therapy, Prosthetics and Orthotics, Psychology, Rehabilitation Nursing, and Speech and Language Therapy. designed to provide “Interventions aimed at optimizing function and reducing disability when individuals with health conditions interact with their environment” have the potential to improve individuals’ functioning and their ability to successfully and optimally interact with their environment Environment . Most of these core rehabilitation specialties have developed their own national and/or international competency frameworks or guidelines to convey professional standards, support education guidelines, curriculum planning and development for entry-level healthcare professionals. Within specific disciplines, help establish individual and service-wide development priorities, forming an integral part of quality assurance when implemented through audits and other mechanisms .
Table 3 Core Professional Competency Framework Professional Organizational Competency Framework Audiology Canadian Audiology and Speech-Language Pathology Consortium Regulatory Body National Audiology Competency Profile Occupational Therapy World Federation of Occupational Therapists (WFOT). lowest bar Occupational Therapist Education 2016 Physical and Rehabilitation Medicine International Society for Physical and Rehabilitation Medicine (ISPRM) Core Curriculum and Competencies for Professional Practice in Physical and Rehabilitation Medicine Physiotherapy World Physiotherapy Physiotherapy Entry-Level Education Guide for the Therapist Profession Prosthetics and Orthotics International Society for Prosthetics and Orthotics (ISPO) Standards for Professional Education in Prosthetics/Orthotics Psychology International Association for Applied Psychology (IAAP) and International Psychological Federation International Declaration of Core Competencies for Science (IUPsyS) Professional Psychology Rehabilitation Nursing Association of Rehabilitation Nurses (ARN) Speech and Language Therapy Competency Model for Professional Rehabilitation Nursing Canadian Federation of Audiology and Speech Pathology National Language Proficiency Profiles for Regulators
WHO Rehabilitation Competency Frameworks
Until recently, there was no competency framework relevant to low-resource and high-resource settings that would complement rehabilitation competencies across all health and social care disciplines. Therefore, the World Health Organization (WHO) was tasked with creating resources to help strengthen Rehabilitation workforce status and release of the Rehabilitation Competency Framework (RCF)  in early 2021. RCF captures what people who provide or support recovery do (activities) and the knowledge and skills that enable quality care and behavior (competencies) Service delivery. It combines activities and competencies in the fields of professional learning and development management in rehabilitation practice and leadership and research. It is a model that conveys the expected or expected performance of the recovering person Different countries and environments to provide quality care and services. The model includes five domains centered around the core values and beliefs that are at the heart of the framework and help shape the behavior of rehabilitation workers and their task performance across all RCFs area.
Figure 2 Infographic of the WHO Rehabilitation Capacity Framework
It is relevant to all rehabilitation discipline specializations and settings. The core values beliefs and competencies and the behaviors that express these can be considered intersectional and apply to all rehabilitation workers at all levels of rehabilitation. this The activities and tasks they contain cover the spectrum of rehabilitation work and not all activities and tasks are relevant to every rehabilitation worker. In contextualizing the RCF Competency Framework, developers should only extract activities and tasks that are relevant to it specific workforce.  Likewise, values and beliefs may be interpreted slightly differently by different people and cultures, and thus may fit to some degree within context-specific competency frameworks.
The Four Core Values are:
- Compassion and empathy
- Sensitivity & respect for diversity
- Dignity & human rights
Four core beliefs that rehabilitation should be:
- Person centred
- Available to anyone who needs it and
- Functioning is central to health.
The Five Domains are:
- Learning and Development
- Management and Leadership
Figure 3 Description of the five domains of the Rehabilitation Competence Framework 
Together, these domains capture how rehabilitation workers behave to perform effectively (competencies) and what they do (activities). The RCF defines a competency as “an individual’s observable ability to integrate knowledge, skills, values and beliefs into their performance” task . Competence is enduring, trainable, and expressed through measurable behaviours” (WHO 2020 p. vii). Activities are “areas of work comprising groups of related tasks. Activities are time-limited and trainable through the execution of missions measurable. (WHO 2020 p. vii). RCFs further decompose their competencies and activities by explaining the practical knowledge (core and activity-specific knowledge) and practical skills (core and activity-specific skills) within each domain. Competencies are decomposed into behaviors; and turning activities into tasks. Each describes four proficiency levels. Each domain also describes the knowledge and skills that underpin activities and competencies. These include core knowledge and skills as well as activity-specific knowledge and skills.
Table.4 Differences between Competencies and Activities CompetencyActivityAssociated with a rehabilitation workerAssociated with a role its requirements and the practice of practice of the specific rehabilitation workerDurable (persisted through different activities) Begin and End are expressed as Behavior contains tasks that are relevant to all rehab workers and are related to some rehab workers and not others based on their role
The RCF is a model that can be used as a tool to guide the entire rehabilitation workforce to facilitate the delivery of quality care . It can be used as a reference for developing a competency framework for a specific environment and is designed to be easily adopted by anyone. Rehabilitation professional setting or specialization. It also provides a structured language and menus with core and optional content relevant to who will use it and what it is for. The Rehabilitation Capacity Framework will not replace or supersede existing national or international Competency frameworks or standards. Conversely, professional societies and regulatory bodies looking to adapt language concepts and structures to improve communication can refer to the Rehabilitation Competency Framework when developing or revising their own competency frameworks or standards and comparability between majors and countries.
Standards of Practice
According to the American Psychological Association’s Dictionary of Standards of Psychological Practice as
A set of guidelines describing the intended techniques and procedures and the sequence in which they are used to intervene in individuals experiencing a range of… conditions.
Standards of practice are the “how-to” of a discipline or clinical profession in that they describe more specifically what is and is not considered good practice in a given discipline. The primary reason for developing standards is to facilitate the guidance and regulation of the profession practice. Standards of practice can include standard operating procedures, clinical practice protocols, and clinical policy statement standards for clinical procedures. Standards set out the legal and professional requirements for rehabilitation practice and describe performance levels Expect rehabilitation professionals in their practice. The standards guide the values of expertise, skills, and judgment required for safe practice by rehabilitation professionals, regardless of the roles and settings in which they may be employed.
Many professional organizations develop standards of practice to ensure practitioners use the most thoroughly researched and validated treatment plans in their field. They effectively support clinicians, management teams and healthcare organizations in developing safe Staffing practices delegate tasks to licensed and unlicensed personnel, ensure adequate documentation, and even create policies for new technologies like social media.
Standards of practice ensure that we take responsibility for our clinical decisions and actions and maintain competence throughout our professional lives. They are patient-focused, promoting the best possible outcome and minimizing the risk of contact injury. These standards encourage us to continually improve Our knowledge base provides continuing education and up-to-date guides through experience. We can use Standards of Practice to identify areas for improvement in the areas of our clinical practice work and improve patient and workplace safety. 
Table.5 Core Occupational Practice Standards Professional Organization Competency Framework Audiology American Academy of Audiology Standards of Practice Occupational Therapy World Federation of Occupational Therapists (WFOT) Scope of Practice and Extended Physical Therapy World Standards of Physical Therapy Physiotherapy Practice Prosthetics and Orthotics World Health Organization Standards for Prosthetics and Orthotics Psychology British Psychological Society Practice Guidelines Association for Rehabilitation Nursing Association of Rehabilitation Nurses (ARN) Professional Rehabilitation Competency Model Nursing Speech and Language Therapy Australian Speech Pathology Australian Speech Pathologist Professional Standards Assistive Technology Rehabilitation Engineering and Assistive Technology North America (RESNA) Pediatric Practice Standards World Health Organization Standards Improving the quality of care for children and adolescents in healthcare facilities
Models of Care
A “model of care” broadly defines the way health services are delivered. It outlines best practice care and services for a specific population or cohort of patients as they go through the stages of a conditional injury or event. It aims to ensure that people are By the right team in the right place at the right time . Models of care often originate in the care management of chronic conditions. These models share many components as they attempt to address multiple determinants of health that are common across different conditions.
The Chronic Care Model is an organizational approach to caring for chronically ill patients in a primary care setting and provides an excellent framework for understanding the rationale for common components across care models. The system is population-based to create practical support Evidence-based interaction between informed activated patients and prepared active practice teams.
Integrated Care Pathways
An Integrated Care Pathway (ICP) is a predefined framework for evidence-based multidisciplinary practice for a specific patient. They have the potential to improve continuity of care, patient safety, patient satisfaction, efficiency, improved teamwork and staff education. it provides an outline Schedule anticipated care within the appropriate time frame to help patients with a specific condition or set of symptoms progress through the clinical experience to positive outcomes. Although changes in pathways may occur in exercising clinical freedom to meet individual needs Patient ICP helps reduce unnecessary variability in patient care and outcomes.  They support the development of nursing partnerships and empower patients and their caregivers. The ICP can also be used as a tool to incorporate local and national guidelines into daily practice risks and meet the requirements of clinical governance. ICP for people with spinal cord injury spans multiple service delivery points, from initial presentation to long-term management in appropriate settings. ICP will include breadth of reference Patient journey and problem solving including pre-hospital care reception and intervention reconstruction and continuum of care (including acute rehabilitation) post-acute and lifelong care.
Integrated care pathways are important because they help reduce unnecessary variation in patient care and outcomes. They support the development of nursing partnerships and empower patients and their caregivers. They can also be used as a tool to incorporate local and national guidelines into daily work The practice manages clinical risk and meets the requirements of clinical governance. When designing and introducing integrated care pathways, it is important to incorporate them into organizational strategy and select appropriate topics that provide opportunities for improvement.
An integrated care approach should address the following issues;
- Who does what?
- Where was it done?
- When is it done?
- How much does it cost?
- Why was it not done?
- What was the valued outcome?
- What is Competence? 
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Integrated Care Pathways
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