(1) Outcome Measures Flashcards
Types of measures
focus of outcome measure (disease specific or generic outcome measures–published normative values)
Mode of administration– Performance based and Self Report
How do objective measures enhance clinical practice?
identifying and quantifying limitations
forming evaluation, dx, and prognosis
informs plan of care
helps evaluate success of PT interventions
What are the aspects of objective measure decision making framework?
what to measure, purpose of measure, type of measure, pt and clinic factors, psychometric factors, feasibility
Purposes of outcome measures
quantify performance or health status
intended to track change in performance
can direct plan of care
determine progress/improvement
help with dx
predict future status
Purposes of outcome measures
discriminative (characteristics or predefined categories)
predictive (future status, identify risk, prognosis, discharge)
evaluative (effectiveness of intervention by evaluating change over time)
these factors closely match the pt goals and tx plan—-Motivation, dependent on stage of recovery, pt capability
patient factors
List examples of psychometric factors
reliability, validity, MDC, MCID
List examples of feasibility factor
time, space, equipment, training, cost, cultural and language limiters, proprietary issues
What is PPS?
Prospective payment system:
method used by centers of medicare/medicaid to determine projected pt length of stay and hospital reimbursement for pts
__________ is the medicare reporting instrument used by inpatient rehab facilities
IRF PAI: inpatient rehab facility – patient assessment instrument
IRF PAI reports standardized quality measures and pt assessment data in what 4 post acute settings?
inpatient rehab, skilled nursing, long-term acute care, home health
IRF PAI replaces FIM as means for determining level of function for what 2 things?
length of stay and reimbursement
IRF PAI must be scored within ______ days of admission and at discharge
3
Inpatient rehab facilities are reimbursed by taking these things into consideration (4)
- admitting dx
- tiered co-morbidities (unrelated to dx)
- admission functional and bowel/bladder scores
- some cases, pt age
What does section BB of IRF PAI assess?
hearing, speech, vision, ability to express ideas and wants as well as to understand verbal content
What does section C of IRF PAI assess?
cognitive patterns
What does section H of IRF PAI assess?
bowel and bladder continence
What does section GG of IRF PAI assess?
Functional abilities and goals
admission - pt’s baseline functional status conducted prior to the benefit of services
PLOF “every day activities”:
self-care, indoor mobility (ambulation), stairs, functional cognition
Prior level of assistance Scoring
3-
2-
1-
8-
9-
3- independent
2- needed some help
*1- dependent (helper does all the effort or assistance of 2 or more helpers is required for pt to complete activity even if it is stand by assist only and does not end up needed hands on assistance!)
8- unknown
9-N/A (pt did not perform immediately prior to current illness, exacerbation, or injury)
The list of devices and aids include: (6 items)
manual WC, motorized WC/scooter, mechanical lift, walker, orthotics/prosthetics, none of the above (no device or other device)
What items are on Mobility for ONLY PTs not OTs
car transfers, walking, steps, picking up object, wheelchair mobility
(OT and PT: roll L to R, sit to lying, lying to sitting on side of bed, sit to stand, chair/bed-to-chair transfer, toilet transfer)
Quality indicator grading
06
05
04
03
02
01
if activity not attempted
07
09
10
88
- independent
- set up/clean up
- supervision or touching assistance (cueing/CGA)
- Partial/Mod assist (helper does less than half the effort)
- substantial/maximal assist (helper does more than half the effort)
- dependent
if activity not attempted
07. pt refused
09. N/A (not attempted and pt did not perform before current illness…)
10. not attempted due to environmental issue (equipment, weather)
88. not attempted due to medical condition or safety concerns
Quality indicator grading:
not attempted due to medical condition or safety concerns
88
