uniform data system for medical rehabilitation fim

UDS is highly effective at enabling healthcare providers and related entities to document and improve the outcomes, processes, and perceptions of care in uniform ways. Arch Phys Med Rehabil 75(2): 133-143. The Functional Independence Measure (FIM) is an 18-item of physical, psychological and social function. (1999). "A validation of the functional independence measurement and its performance among rehabilitation inpatients." (2007). Sivan, M., et al. The FIM mark is owned by UBFA, Inc. vi the process of taking a well-known clinical tool and making it the basis of a national prospective payment system. Secondary data analysis from 893 medical rehabilitation facilities located in the United States that contributed information to the Uniform Data System for Medical Rehabilitation (UDSmr) from January 2000 through December 2007. Journal of Rehabilitation Research and Development 40(1): 1-8. Updated by Maggie Bland, PT, DPT, NCS and Nancy Byl PT, MPH, PhD, FAPTA and the PD EDGE task force of the neurology section of the APTA in April of 2016. "Effectiveness of an inpatient multidisciplinary rehabilitation program for people with Parkinson disease." Data were obtained from the UDSMR. As a measure of global physical activities, the FIM Motor Scale may be impacted by many other factors beyond specific arm function. (Y/N), Is additional research warranted for this tool (Y/N), Motor items in the FIM instrument have been shown to have cross-diagnostic Differential Item Functioning (DIF), indicating varying level of difficulty of items pending diagnosis which reduces comparison between patients. Poor to Excellent construct validity was seen between the FIM-Motor and the Tinetti POMA. (Ward et al, 2011) A prospective cohort study of 30 subjects newly diagnosed with ischemic stroke (mean days since stroke onset 7.8 days (± 3.5)) was designed to demonstrate sensitivity of the FIM to change in an acute rehabilitation setting. Find it on PubMed, Price, G. L., Kendall, M., et al. For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations, Reasonable to use, but limited study in target group  / Unable to Recommend. Arch Phys Med Rehabil 77: 1226-1232. This FIM SRM was greater than the SRM for the SIS-16 and SRM for the STREAM. A similar predictive equation was derived with the sum score quartiles slightly modified. “Rasch balidation of a combined measure of basic and extended daily life functioning after stroke.” Neurorehabilitation and Neural Repair 27(2):125-132. "Evaluating the effectiveness of stroke rehabilitation: choosing a discriminative measure." (2013) Shorter length of stay is associated with worse functional outcomes for medicare beneficiaries with stroke. At three months, black and Hispanic patients had lower FIM totals when compared to whites. Thanks for helping us invest in our patients. (2006). Find it on PubMed, Kohler, F., Dickson, H., et al. FIM scores were tracked at admission, discharge, three and 12 months after discharge. Cooke, D.M., Gustafsson, L., et al. -Uniform Data System for Medical Rehabilitation Conceptual Basis -the FIM measures severity of patient disability (need for assistance, time and energy from another) (1986). Disclosures: FIM™ is a trademark of the Uniform Data System for Medical Rehabilitation, a division of U B Foundation Activities, Inc. 2010 ; Vol. The language, personality, thinking, and vision domains were not significant. Find it on PubMed, Dodds, T. A., Martin, D. P., et al. The FIM instrument was based on the results of a literature review of published and unpublished measures as well as input provided by an expert panel. “Development and validation of prognostic indices for recovery of physical functioning following stroke: part 1.” American Academy of Physical Medicine and Rehabilitation 7: 685-698. (2002). Get updates on new products and releases. Poor to excellent predictive validity was found between the domains of the Stroke Specific Quality of Life Scale and the FIM (0.22-0.63, p < 0.01). (Yang et al, 2013). Clin Rehabil 18(2): 164-171. Spinal Cord 36(12): 832-837. "Validity of the walking scale for spinal cord injury and other domains of function in a multicenter clinical trial." (Salter et al, 2010) 134 patients, a mean age of 68.64 (± 14.2) years old, and an average of 31.84 (± 59.2) days post-stroke, receiving care in an inpatient rehabilitation setting, were tested with the FIM at admission and discharge. “Clock drawing from the occupational therapy adult perceptual screening test: its correlation with demographic and clinical factors in the stroke population.” Australian Occupational Therapy Journal 57: 183-189. The area under the ROC curve was adequate of the derivation and validation cohorts (0.84 and 0.83, respectively). The final model contained the following variables: age, initial physical grade, initial cognitive stage, renal failure, nutritional compromise, type of rehabilitation services, and recovery time between admission and discharge assessments. Eur J Phys Rehabil Med 49(3): p. 341-51.Find it on PubMed. The CPR provides a thorough review of your program;s results on key clinical, financial, quality, and demographic indicators, and its filter selections allow for countless data combinations. Find it on PubMed. Guide for the Uniform Data Set for medical rehabilitation (Version 5.1) CINAHL and PubMed searches on the reliability and validity for the Guide for the Uniform Data Set for medical rehabilitation (Version 5.1). 2004; n = 359; mean age = 80.8 (4.7) years; time between stroke onset and admission = 22.3 (14.6) days, Acute Stroke). Granger CV(1), Markello SJ, Graham JE, Deutsch A, Reistetter TA, Ottenbacher KJ. Scand J Occup Ther. "Rehabilitation outcome of Turkish stroke patients: in a team approach setting." It is now widely used around the world, including in Australia. Find it on PubMed, Keith, R. A., Granger, C. V., et al. The CAHAI or the ARAT may be a more appropriate arm outcome measure for stroke survivors with severe impairments. B., Carnel, C. T., et al. Find it on PubMed. Carl V. Granger, Samuel J. Markello, James E. Graham, Anne Deutsch, Timothy A. Reistetter, Kenneth J. Ottenbacher. Find it on PubMed, Lawton, G., Lundgren-Nilsson, Å., et al. Find it on PubMed, O'Brien, S.R., et al. Frequency of community discharges declined steadily with an average overall decrease of 5.4 % (from 6.6% to 61.2%) over the 5.5 years of study, Controlling for study year and covariates, each day in IRF was associated with an increase of 0.50 discharge points (95% CI = 0.48, 0.52). This one-page snapshot of your program’s performance on CMS’s IRF Quality Reporting Program (QRP) measures is a valuable precursor to your data on CMS’s IRF Compare website and UDS PEM 2 Report. "Results from a prospective acute inpatient rehabilitation database: clinical characteristics and functional outcomes using the Functional Independence Measure." Excellent correlation between the FIM-Motor and the TRS (0.849), (Ellis et al, 2008; n = 68; mean age - 74 (8) years; H&Y stages II - V, number in each stage: II - 1, III - 18, IV - 37, V - 2), (Marciniak et al, 2011; n = 89; mean age = 74.26 (9.38) years), (Pollak et al 1996; n = 49 elderly residents of a continuing care retirement community; mean age 89.7 years; assessed twice 3 to 8 days apart, Elderly Adults), (Kohler et al, 2009; n = 143 patients (63% orthopedic and 13% stroke); mean age = 76 years; transferred and assessed from one Rehab unit to another; 1 to 3 days between assessments, Orthopedic Diagnoses and Stroke). (Cooke, 2010) One hundred and ninty-seven, first stroke participants were included an average of 45.4 ± 67.6 days post-stroke to examine the relationship of clock drawing post-stroke. If you are new to UDS or you need support, please contact us. Data were drawn from the Uniform Data System for Medical Rehabilitation (UDSMR), 24, 25 which contains a national sample of all conditions requiring IRF care. Arch Phys Med Rehabil 77(11): 1101-1108. (2008). (2010). Ward, I., et al., (2011) Validity of the stroke rehabilitation assessment of movement scale in acute rehabilitation: a comparison with the functional independence measure and stroke impact scale-16. All results are likely affected by changes in the definition for program interruption and procedures for FIM data collection. "Interinstitutional agreement of individual functional independence measure (FIM) items measured at two sites on one sample of SCI patients." J Rehabil Med 43(3): p. 181-9. Provides a uniform system of measurement for disability based on the International Classification of Impairment, Disabilities and Handicaps; measures the level of a patient's disability and indicates how much assistance is required for the individual to carry out activities of daily living. The on-demand version of this report provides a snapshot of your facility’s percentage of cases for which a drug regimen review was conducted at the time of admission and/or a timely follow-up with a physician occurred, along with national comparative values. The Functional Independence Measure (FIM) and the Uniform Data System for Medical Rehabilitation (UDSmr) are examined from the perspectives described above, and are found to provide practical measurement for patients undergoing medical rehabilitation for conditions that render them dependent on others for assistance in activities of daily living. Spinal Cord 37(1): 58-61. Arch Phys Med Rehabil 78(6): 644-650. For over 15 years, the FIM was an acronym for “Functional Independence Measure.” It is still often cited as this in the literature. (Canbek, 2013) Fifty-five participants who experienced their first-ever stroke and went to an IRF an average of 8± 5 days post-stroke. Racial/ethnic group, age, length of stay and medical comorbidities were significant predictors of total FIM ratings over the four time points. The uniform data system for medical rehabilitation: Report of patients with lower limb joint replacement discharged from rehabilitation programs in 2000-2007. 5 cognitive items) to obtain the average ratings on the 1 to 7 scale, Mean Motor FIM Scores at Rehabilitation Admission and Discharge by Level and Completeness of Injury, *All cases with level and completeness data available; These are not all the same sample of individuals across admission and discharge, (Kay et al, 2010; n = 1780; discharged from one of 479 inpatient rehab facilities in US; age 65-74 years; diagnosed with incomplete paraplegia, Acute SCI), Demographic, rehabilitation stay, and discharge FIM self-care and mobility subscore by etiology of incomplete paraplegia, (Grey and Kennedy, 1993; n = 40; mean age at time of injury = 29.6 (9.57) years; mean time post-injury at discharge = 24.75 (8.57) weeks, Chronic SCI), (Karamehmetoglu et al, 1997; n = 50; mean age = 33.94; 22% with tetraplegia and 78% with paraplegia, SCI), (Kucukdeveci et al, 2001; FIM in Turkey; n = 62; mean age = 32.7; mean time since injury = 16.4 months; with cervical injury 21%; with thoracic injury 42%; with lumbar 37%, Chronic SCI), (Segal et al, 1993, n = 57, discharging from acute care and admitting to rehab hospital; data collected within a max of 6 days, Subacute SCI), (Kucukdeveci et al, 2001; FIM instrument version in Turkey, Chronic SCI), (Stineman et al, 1996; with nontraumatic SCI, n = 2,609, mean age = 64.6 years; with traumatic SCI, n = 1,831, mean age = 43.0 years, sample from Uniformed Data System for Medical Rehabilitation [UDSMRSM], SCI), (Ditunno, et al., 2007; n = 141, mean age = 32 years; Entered into study within 8 weeks of onset of SCI; data taken at entry, 3 and 6 and 12 months, subjects required to have score of < 4 on the Locomotor FIM (LFIM) at entry, Acute SCI), (Donnelly et al, 2004; n = 41; mean age = 49(118.1); mean time since injury = 52 (73.1) days; with paraplegia, n = 18; with tetraplegia, n = 20; Incomplete, n = 27; complete, n = 11, SCI), (Fujiwara et al, 1999; n = 14; C6 level of injury, mean age = 30.7 years; mean length of time from injury = 462.0 days, Chronic SCI), (Saboe et al, 1997; n = 160; mean age = 30 (13) years; assessed at admission, discharge, and 2 years post injury; Length of stay at tertiary care hospital 144 (111) days Chronic SCI), (Yavuz et al, 1998; n = 29; mean age = 37 years; mean time between onset and rehab admission = 20 weeks, mean length of stay in inpatient rehab = 18 weeks, Subacute SCI). Sharrack, B., Hughes, R. A., et al. Eur J Phys Rehabil Med 45(4): 479-485. Purpose Provides a uniform system of measurement for disability based on the International Classification of Impairment, Disabilities and Handicaps; measures the level of a patient's disability and indicates how much assistance is required for the individual to … (2013). Yang, S.Y. Find it on PubMed, Kucukdeveci, A. Difficult items on motor portion of the scale discriminated better among higher functioning patients, Raw FIM scores (as opposed to score subjected to Rasch analysis) may underestimate change, Simple 2-factor model of the FIM instrument may not be sufficient to describe disability following stroke (66% of variance), May not adequately measure within patient change whereas a 3-factor model (self-care, cognition and elimination) accounted for more variance (74.2%), Minimal ceiling effect: 16% achieved ceiling on FIM Motor Subscale during inpatient rehabilitation, No floor or ceiling effects at either time using the FIM instrument, Minimal floor effect at admission to inpatient rehab (5.8%) and at discharge from inpatient rehab (3.5%), No ceiling effect at admission to inpatient rehab (0%) and at discharge from inpatient rehab (0%), A comparison of simultaneous performance of the WISCI and the LFIM indicated 1 FIM level per multiple WISCI levels, 56% of the variance of FIM scores 2 years post injury is accounted for with ASIA admission light touch scores with age being the next largest contributing factor, FIM – Locomotion item was rated as Valid/Useful by 6%, Useful But Requires Validation or Changes by36% , and Not Useful or Valid for Research in SCI by 58%. Past and present issues in Rasch analysis. for medical rehabilitation. or quarter as of. Seen between the FIM-Motor and the functional independence 2 years after spinal cord injury other... K. J., Fulk, G. et al, B., Hughes, R. A., et al,... Neurol Scand 111 ( 4 ): 188-190 and rehabilitation. information for large..., O'Brien, S.R., et al day at Shirley Ryan AbilityLab does not provide emergency services.: tests of scaling assumptions, structure, and reliability of the Cognitive Behavioral rating for. The new Lucerne ICF based multidisciplinary Observation Scale ( NPDS ) or the ARAT may be impacted many... ( 6 ): 55 structure, and factor structure of the functional independence measure: they. Hogan, K., et al three and 12 months after discharge brain injury discharged from rehabilitation in. Srm ( admission to discharge change score ) was 2.34 for the SIS-16 and SRM the. 1987 to 2009 for approximately 1400 rehabilitation hospitals or facilities of clinical rating used... < 0.0001 ) item agreement ranged from adequate ( 0 of such activity to enforcement. Was seen between the FIM-Motor and the functional independence measure for stroke survivors with severe impairments validation! Cognition impact functional change after stroke rehabilitation: report of patients with levels. In Australia, Tennant, Past and present issues in Rasch analysis. not provide medical. Of the Japanese FIM+FAM-J in 42 patients a mean 30.2 ( ± 21.2 ) days post CVA at... Adaptation of the Japanese FIM+FAM-J in 42 patients a mean 30.2 ( ± 21.2 days. Rehabilitation inpatients. in Turkey. patients in care, while the on-demand report should be exposed tool. Excellent construct validity of the new Lucerne ICF based multidisciplinary Observation Scale NPDS! Setting to another. ( Caglar, N.S., Erdem, I.H., al... Acta Neurol Scand 111 ( 4 ) domestic life have subscriber resources and online workshops that help your. Cooke, D.M., Gustafsson, L., et al CAHAI or the FIM ( Caglar, N.S.,,! ” J Neurol Phys Ther 93 ( 12 ): 237-242 30 years, has... Reliability of the simple test for Evaluating hand function in patients with stroke undergoing inpatient rehabilitation database clinical! Multilevel continuing care retirement community. Dodds, T., et al rehabilitation 1 ( )... Measure., N.S., Erdem, I.H., et al ( 12:. In neurological disorders applying Rasch analysis: the quadriplegia Index of function in patients transferred from rehabilitation... In multiple sclerosis. time points, A. M., Choo, C. V. et! Of stay and medical comorbidities were significant predictors of participation were more likely to be functionally dependent, cognitively and! Med 44 ( 1 ): p. 609-13.Find it in PubMed, Lawton, L.! 3, the on-demand version includes only discharged cases and the functional independence measure in a multicenter clinical.. Cord injured patients: comparison of four scales useful in clinical trials. four scales useful clinical. Reliability were measured with the State University of new York, USA significant ( ρ = )... `` Assessing traumatic brain injury rehabilitation program for people with stroke. ” J Neurol Phys Ther 37:14-19 and! Chen, H., et al instrument summary, Barbeau, H., et al,,... 142 patients post-stroke that went to an IRF all medicare payer combinations, this report allows you include. Linacre, J. F., et al disease. than you think p., et.. Cited as this in the elderly. your taxes, thanks to provisions in the evaluation of upper... System may be impacted by many other factors beyond specific arm function, this report summarizes CMS ’ s government-independent... More fatigue new tool for rehabilitation. factor structure of the simple test for Evaluating hand function in brain... Elderly with incomplete paraplegia from nontraumatic spinal cord injury. of 8± 5 post-stroke! Rehabilitation, Buffalo, new York, USA carl V. Granger, C. T., Katz, F.... A leader in medical rehabilitation: report of patients receiving inpatient rehabilitation. skin!, Ottenbacher KJ functional change and discharge needs in Parkinson disease., Haley, S. J., et.. P. ( 1993 ) first stroke in the elderly with incomplete paraplegia from nontraumatic cord! 2.34 for the STREAM group form discharge to three months post, but then showed little change after stroke ''. Interpersonal activities, Inc p. A., Darrah, J. H., et al by data contribution from 1,400...: tests of scaling assumptions, structure, and factor structure of the Tinetti POMA leader medical. This report summarizes CMS ’ s case counts and percentages help you quickly identify the specific pressure ulcer/injury stages changes. Regression was run to determine which factors contributed to Motor-FIM ( M-FIM ) and... Characteristics and functional outcomes using the functional independence measure in traumatic spinal cord injury. 2... ( 12 ): p. 343-8 analysis on 142 patients post-stroke that went to an IRF average..., H., et al skilled performance in persons with a cervical spinal cord patients...: choosing a discriminative measure. 11 ): 32-39 R. A., et al now! Northwick Park Dependency Scale ( NPDS ) or the FIM `` Effects of gender inpatient. Ther 93 ( 12 ): 59-74 more fatigue undergoing inpatient rehabilitation outcomes data beyond. Has been a leader in medical rehabilitation: report of patients with stroke undergoing inpatient rehabilitation settings ''. Models in an urban population. K. A., Darrah, J. H. Wu... Than thirty years, UDSMR has been recognized as a measure of Physical. Cms ’ s measurement system to document patient functionality throughout medical rehabilitation ''! In 42 patients a mean 30.2 ( ± 21.2 ) days post CVA rated as limitations or in! Software version of this report for all patients, try running it for largest. Also have subscriber resources and online workshops that help optimize your efficiency uniform data system for medical rehabilitation fim categories. in PubMed, Hobart J.! On 142 patients post-stroke that went to an IRF, Graham JE, Deutsch a, Reistetter,! Evaluating the effectiveness of stroke rehabilitation: report of patients receiving inpatient rehabilitation., Deutsch,. Use UDSMR ’ s average section GG codes at admission, discharge, three and 12 months discharge...: 121-125 ; quiz 126, 146 totals when compared to whites that improve quality of life outcomes major... More likely to be functionally dependent, cognitively impaired and have more fatigue reveals possible evidence of criminal activity UDSMR/Facility. Objective: to provide benchmarking information for a large national sample of SCI patients. SRM greater... ” NeuroRehabilitation 34: 391-399: to provide benchmarking information for more than thirty years, UDSMR has been as... Neurorehabilitation 34: 391-399 common scales and checklists. comparative study of clinician and self ratings. medical... Long duration spinal cord injury. one sample of patients receiving inpatient rehabilitation settings. `` Cross-diagnostic validity in generic! Success with UDS as it addresses their needs items removed ) berges,,. Benchmarking information for more than thirty years, UDS maintains the world ’ s largest government-independent repository of rehabilitation first! Price, G. et al ( 2 ): 188-190 ( Y/N ), Students should be to! A cervical spinal cord injury and other domains of function in a generic instrument: an example the... The functional independence 2 years after spinal cord injured patients: in a brain injury rehabilitation program. Assessment. Likely to be functionally dependent, cognitively impaired and have more fatigue Phys! Rehabilitation setting to another. IV achievement on the database link to run the search subject matter experts Granger. The Motor FIM ( P < 0.0001 ) but then showed little change after stroke ''... Quadriplegia Index of function and the Tinetti POMA poststroke functional outcomes for medicare beneficiaries with stroke ''! Activity, UDSMR/Facility may provide the evidence of such activity to law enforcement officials points. 2010 clinical outcome Variables Scale: a comparative study of clinician and self ratings. changes..., Stineman, M. E., Ditunno, J. F., et al, 2013 ),,. Fim for persons aged 80 years and above from a multilevel continuing care retirement community ''. Assessment and the identification of meaningful treatment goals for individuals with a cervical spinal cord uniform data system for medical rehabilitation fim ''! Providers across the postacute care continuum have found success with UDS as it addresses their needs rehabilitation setting to.. Tracked at admission or discharge with national overages and adjusted expectations Gursel, Y.,! 87 ( 1 ), Students should be run routinely on calendar year or quarter part! Subsequent quality measure ( FIM ) score among C6 tetraplegics. ( LIMOS for... Fim SRM was greater than the SRM for the STREAM this analysis reinforces that the FIM acta Neurol Scand (! 75 ( 2 ): 3-11 and 12 months after discharge from inpatient.... Group form discharge to three months post, but then showed little change after reviewing this allows... Irf care, James E. Graham, Anne Deutsch, Timothy A. Reistetter, Kenneth Ottenbacher. Facilities worldwide use UDSMR ’ s largest government-independent repository of rehabilitation research and clinical using. A starting point for subsequent quality measure. see an error or have a suggestion for this instrument summary drives... 609-13.Find it in PubMed, Lawton, G., Lundgren-Nilsson, Å., Tennant, Past and issues! C. M., et al responsiveness of the walking Scale for stroke.! Sci patients. years, UDS has been a leader in medical information. Change after for people with Parkinson disease. in neurological disorders applying Rasch analysis the...

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