Activity Measure for Post Acute Care (AM-PAC) for Occupational Therapy

Suzie Kwon, MOTSSwedish Medical Center, First Hill

September 7th, 2016

Important in discharge planning

Standardized assessment of patient’s function

Need for an Objective Outcome Measure

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

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

• 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

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

Grooming & Hygiene

Feeding and Meal Preparation

Personal Care

http://am-pac.com/category/domains/

Daily Activity Domain

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

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”

80 patients in inpatient acute care at Swedish First Hill

Time period: 8/10 /16– 9/2/16

AM-PAC scores throughout their inpatient stay

Trial

AM-PAC possible raw score range: 6-24 Lowest raw score: 6 Highest raw score: 23 Average raw score at eval during our trial: 16.18 Average raw score at discharge during our trial: 16.91

Data

Considerations

Next Steps: .ampacot for SmartPhrase Applied Cognitive domain for inpatient Speech &

Language Pathology team

Trial Outcomes

The patients at Swedish Medical Center, First Hill

Lauren Anderson-Connolly, OTR/L

Thank You!

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

Questions?