1. Getting Started Consuelo B. Gonzalez-Suarez, MD, PhD
University of Santo Tomas
Philippine Academy of Rehabilitation Medicine

5. Mission
To promote and advance the field of rehabilitation medicine, elevate the standards of practice through training, education, research and service thereby improving the quality of life of the Filipino people.
Vision
The PARM is a nationally-recognized and globally-accepted society to dynamic, compassionate and highly competent rehabilitation medicine specialists (Physiatrists) at the forefront of comprehensive healthcare of the Filipino people.

6. Objectives
Understand the important issues on the developing a clinical practice guideline
Identify enablers that facilitated the development of CPG
Create a patient’s journey

7. Identification of important issues
Lack of local knowledge and available training regarding evidence-based practice
Not all medical and paramedical schools are offering evidence based research
Lack of time and resources to construct de novo guidelines
Requirement of the government to develop CPGs for the National Health Insurance

8. Identification of important issues
Small numbers of relevant Filipino research studies
Lack of evidence-based practice culture
Most guidelines are developed in Western countries where practice may be different from the Philippines
Lack of a leader in the evidence-based practice movement

9. Enablers
Overt support for guidelines implementation from the Philippines Department for Health
Growing awareness of the use of evidence-based practice
Interest from Filipino universities in using an evidence-based model for training healthcare providers
Wider access to the Internet

10. Enablers
General desire within the PARM group and amongst policy-makers to improve healthcare practices and patient outcomes in the Philippines
Urgent need to address the ramifications of the high incidence in all parts of the country of disabling conditions amongst Filipinos

11. Preliminary research Health workforce
Difference of healthcare practice in rural and urban areas
7100 islands which have mostly primary hospitals;
Tertiary hospitals are only in cities of the different provinces
Identifying important health conditions
Stroke
Low back pain

12. Establishing our teams
Physicians and residents in training
Knowledge in evidence-based practice is varied
Guideline construction principles
On-going mentorship and peer review through the guideline writing process

13. Establishing our teams

14. Patient Journey
Patients follow a series of care pathways implemented by healthcare professionals
When patient is admitted in the hospital
When patient is treated in the out patient department
Involved physical examination, diagnostic procedures, treatment strategies

15. Stroke Out Patient Journey
Stroke Patient referred at out patient
rehabilitation clinic
Initial Rehabilitation Evaluation
Treatment
Physical therapy
Occupational Therapy
Speech therapy
Pharmacologic management
Provision for orthosis and walking aids
Reassessment
Modification of rehabilitation prescription
Assistive device, mobility aids, splints and orthosis
Fall Assessment
Pain and spasticity Management
Treatment of post-stroke complications
Instructions for home care
Referral to other specialists as needed
Secondary prevention
Reintegration to community
Continuation of care
Treatment of residual neurological deficits
Improvement of cardiovascular and muscular endurance

16. Thank you very much!