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 patients 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 . . .油 1. Putting油on油and油taking油off油regular油lower油body油clothing?油油 2. Bathing油(including油washing,油rinsing油and油drying)?油 3. Toileting,油which油includes油using油toilet,油bedpan油or油urinal?油 4. Putting油on油and油taking油off油regular油upper油body油clothing?油油 5. Taking油care油of油personal油grooming油such油as油brushing油teeth?油油 6. Eating油meals?油 Total Raw Score can convert to G Code and % impairment 6-Clicks
- 10. 80油patients油in油inpatient油acute油care油at油Swedish油First油Hill Time油period:油8/10油/16油9/2/16 AM-PAC油scores油throughout油their油inpatient油stay Trial油
- 11. AM-PAC油possible油raw油score油range:油6-24 Lowest油raw油score:油6 Highest油raw油score:油23 Average油raw油score油at油eval油during油our油trial:油16.18 Average油raw油score油at油discharge油during油our油trial:油16.91 Data
- 12. Considerations Next油Steps:油 .ampacot油for油SmartPhrase Applied油Cognitive油domain油for油inpatient油Speech油&油 Language油Pathology油team Trial油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
- 15. Questions?
Editor's Notes
- #2: I will be talking about Activity Measure for Post Acute Care, or AM-PAC for use in inpatient OT at SMC.
- #3: Acute care OTs and PTs play an important role in discharge planning Having a standardized assessment of a patients function is useful for discharge recommendations, so that its in a way easily understood by other members of the team such as doctors, nurses, social workers, etc.
- #4: The first studys 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.
- #5: 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
- #6: 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.
- #7: Functional activity is multidimensional
- #8: Important aspects of daily occupations for self-care that can determine the level of care the pts may need at discharge
- #10: You can use your clinical judgment
- #13: 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?
- #15: http://am-pac.com/category/domains/ http://am-pac.com/category/population/ http://pac-metrix.com/am-pac-resources/am-pac_short-form/