View
224
Download
0
Category
Preview:
Citation preview
FIM® RatIng ROUnDSMargaret Freckleton, Msn, Rn, CRRn®, LHCRM, Hospital Educator
Omaira Riano, Msn, Rn, CRRn®, CnOHealthsouth sunrise Rehabilitation Hospital
Introduction• Assessment of functional status is a major duty for
clinicians practicing in rehabilitation facilities.
• FIM® rating rounds are done daily, seven days a week by clinicians caring for the patient being reviewed.
• FIM® rating rounds are done on day three of patient admission date.
• This process focuses on admission FIM® scores.
• The purpose of admission FIM® rating rounds is to capture the true burden of care.
• The lower the admission FIM® score, the greater the burden of care.
• The goal is to maximize the patients’ functional independence.
• Confirm and validate that the documentation supports the burden of care reflected in the admission and discharge FIM® score.
ReferencesCenter for Disease and Medicare Services. (2012)
The inpatient rehabilitation facility patient assessment (IRF) training manual. Retrieved March 28, 2013, from www.cms.gov/...Fee.../InpatientRehabFacPPS/.../IRFPAI-manual-2012.pdf
Dodds, T. A., Martin, D. P., Stolov, W. C., & Deyo, R. A. (1993). A validation of the Functional Independence Measurement and its performance among rehabilita-tion inpatients. Archives of Physical Medicine and Re-habilitation, 74(5), 531–536.
ConclusionSince the implementation of FIM® rating rounds:
1. FIM® score changes and patient outcome has improved.
2. Patients length of stay has decreased.
3. Clinicians have a better knowledge of accurately scoring FIM® components.
©2013:HealthSouth Corporation:621330
team Members and Responsibilities
PPS nURSEFacilitate
Discussion
CHaRgE nURSE
Examine day one nursing FIM® scores.
Report discrepancies between nurse and CNA documentation to hospital educator.tHERaPISt
Review and clarify therapist documentation to achieve FIM® score accuracy.
HOSPItaL EDUCatOR
Review day two nursing documentation.
Provide staff education as needed.
nURSIng aSSIStant
Review three days of non-credential FIM® score.
Collaborate with nurse to ensure accuracy.
PRIMaRY CaRE nURSE
Review and discuss day three nursing documentation.
Collaborate with CNA to ensure accuracy.
16.8 15.9 15.4 15.2
18.3 18.1 17.7 17.6
5
10
15
20
2010 2011 2012 2013
FACILITY NATION
SPHINCTER ADMIT SCORE
6.9 7.1 7 6.8 6.6 6.7 6.7 6.6
2
4
6
8
2010 2011 2012 2013
FACILITY NATION
54.4 52.2 50.4 49.5
20
30
40
50
60
2010 2011 2012 2013
ADMIT FIM® SCORE
COGNITION ADMIT SCORE
20.8 19.1
18.3 17.7
23.1 22.8 22.6 22.3
5
10
15
20
25
2010 2011 2012 2013
FACILITY NATION
83.6 85.5 87.5 88
30
40
50
60
70
80
90
2010 Prior to Implementing
FIM® Rating Rounds
2011 2012 2013
DISCHARGE FIM® SCORE
29.3
33.3
37.2 38.5
27.5 28.6 29.8 30.8
14.3 14.7 14.4 14.1
10
15
20
25
30
35
40
2010 Prior to Implementing
FIM® Rating Rounds
2011 2012 2013
FACILITY TOTAL FIM® SCORE NATION ADJUSTED FACILITY LOS
29.3
33.9 37.2 36.5
5
10
15
20
25
30
35
40
2010 Prior to Implementing
FIM® Rating Rounds
2011 2012 2013
FIM® SCORE CHANGE
FIM® Score Changes Self Care admit FIM® Score Sphincter admit FIM® Score
admission FIM® Scores Discharge FIM® Scores FIM® Score Changes
Cognition admit FIM® Score
The Continuum of Care: Navigating the Road to Recovery
Recommended