7DS Board Assurance Framework: Planning or June 2019 submission
Activity Measure for Post Acute Care (AM-PAC
1. Activity Measure for Post Acute
Care (AM-PAC) for Occupational
Therapy
Suzie Kwon, MOTS
Swedish Medical Center, First Hill
September 7th
, 2016
2. ∗ Important in discharge planning
∗ Standardized assessment of patient’s function
Need for an Objective Outcome Measure
3. ∗ Evidence of the accuracy of “6-Clicks” scores for
predicting destination after discharge from an acute
care hospital (Jette et al., 2014).
∗ Evidence for the validity of “6-Clicks” scores for
assessing patients' activity limitations in acute care
settings (Jette et al., 2014).
Supporting Evidence
4. ∗ Provides a quantitative score
∗ Can be used across patient diagnoses, conditions, and
settings
∗ Can predict level of care at discharge
http://pac-metrix.com/am-pac-resources/am-pac_short-form/
AM-PAC Design
5. • Acute hospital
• Inpatient rehabilitation
• Post-acute care
• Hip fracture
• Stroke
• Cancer
• Geriatric
• Orthopedic impairments
• Medically complex cases
http://am-pac.com/category/population/
Intended Population
6. Three functional domains:
•Basic Mobility- Physical Therapy
•Daily Activity- Occupational Therapy
•Applied Cognitive- Speech & Language Pathology
http://am-pac.com/category/domains/
Inpatient “6-Clicks” Short Forms
7. ∗ Grooming & Hygiene
∗ Feeding and Meal Preparation
∗ Personal Care
http://am-pac.com/category/domains/
Daily Activity Domain
8. ∗ Unable-1 (total assistance or dependent)
∗ A Lot-2 (moderate to maximum assistance)
∗ A Little-3 (minimal/contact guard/supervision)
∗ None-4 (independent/modified independent)
“6-Clicks” Scoring
9. ∗ How much help from another person does the patient currently
need . . .
1. Putting on and taking off regular lower body clothing?
2. Bathing (including washing, rinsing and drying)?
3. Toileting, which includes using toilet, bedpan or urinal?
4. Putting on and taking off regular upper body clothing?
5. Taking care of personal grooming such as brushing teeth?
6. Eating meals?
∗ Total Raw Score can convert to G Code and % impairment
“6-Clicks”
12. ∗ Considerations
∗ Next Steps:
∗ .ampacot for SmartPhrase
∗ Applied Cognitive domain for inpatient Speech &
Language Pathology team
Trial Outcomes
13. ∗ The patients at Swedish Medical Center, First Hill
∗ Lauren Anderson-Connolly, OTR/L
Thank You!
14. ∗ Jette, D. U., Stilphen, M., Ranganathan, V. K., Passek, S. D.,
Frost, F. S., & Jette, A. M. (2014). AM-PAC “6-Clicks”
Functional Assessment Scores Predict Acute Care Hospital
Discharge Destination. Physical Therapy, 94(9), 1252-1261.
Accessed September 01, 2016.
http://dx.doi.org/10.2522/ptj.20130359.
∗ Jette, D. U., Stilphen, M., Ranganathan, V. K., Passek, S. D.,
Frost, F. S., & Jette, A. M. (2014). Validity of the AM-PAC “6-
Clicks” Inpatient Daily Activity and Basic Mobility Short
Forms. Physical Therapy, 94(3), 379-391. Accessed
September 01, 2016.
http://dx.doi.org/10.2522/ptj.20130199.
References
I will be talking about Activity Measure for Post Acute Care, or AM-PAC for use in inpatient OT at SMC.
Acute care OTs and PTs play an important role in discharge planning
Having a standardized assessment of a patient’s function is useful for discharge recommendations, so that it’s in a way easily understood by other members of the team such as doctors, nurses, social workers, etc.
The first study’s objective was to determine the accuracy of “6-Clicks” basic mobility and daily activity measures for predicting discharge from an acute care hospital to a home or institutional setting.
The aim of the second study was to provide evidence for validity of scores on Activity Measure for Post-Acute Care (AM-PAC) “6-Clicks” measures of basic mobility and daily activity in acute care. Validity was analyzed by examining differences in “6-Clicks” scores across categories of patient characteristics; the ability of “6-Clicks” scores to predict patients' having more than one therapy visit; correlation of “6-Clicks” scores with Functional Independence Measure (FIM) scores; and internal responsiveness over the episode of care.
The AM-PAC design provides a quantitative score easily understood by other professions, and
Unlike traditional functional outcome measures which are disease, condition, or setting specific, the AM-PAC can be used across pt dignoses, conditions, and settings in acute care and measures functional outcomes.
It is designed for examining functional outcomes over an episode of post acute care, as patients move across institutional and community-based care settings.
It can also predict discharge level of care from an acute care hospital to a home or facility
The AM-PAC is validated for use with post acute care patients with major medical, orthopedic, and neurologic impairments. It has been tested in many mixed populations as shown in this slide.
Functional activity is multidimensional
Important aspects of daily occupations for self-care that can determine the level of care the pts may need at discharge
You can use your clinical judgment
Some considerations:
We were not always able to see the same patients from eval all the way through d/c. This would have been interesting to see the whole treatment course.
Some patients declined at first, then improved in function and discharged from the C rotation. It would have been useful and interesting to see if the AM-PAC could have been used across the rotations by all therapists to see his trend.
Providence extending license to Swedish. Supervisor discretion to share the SmartPhrase from here on.
Cognitive/SLP- future considerations for Swedish?
