Freeman L.1,2, Leland N.3, Cummins B.4, Besch M.5, Cheng S.6, Ottenbacher K.7
1Aegis Therapies, Office of Research, Plano, United States, 2Post-Acute Therapeutics and Health Clinical Research Institute, Office of Research, Sammamish, United States, 3University of Southern California, Occupational Therapy, Los Angeles, United States, 4Post-Acute Therapeutics and Health Clinical Research Institute, Office of Research, Anacortes, United States, 5Aegis Therapies, Clinical Services, Plano, United States, 6NOVA Southeastern, Physical Therapy, Fort Lauderdale, United States, 7University of Texas Medical Branch, Division of Rehabilitation Sciences, Galveston, United States
Background: The emergence of electronic medical records (EMRs) provides new opportunities to examine post-acute care (PAC) population changes in function. However, little is known about the reliability and validity of existing measures and the relationship to outcomes.
Purpose: To evaluate clinometric properties of the Physical Therapy (PT), Occupational Therapy (OT), and Speech Language Pathology (ST) Rehabilitation Outcome Measure (ROM) and its relationship to function.
Methods: Secondary analysis of OT, PT, and ST EMRs of patients admitted to one of three nursing homes between January 2012 and December 2014. ROM scores were collected at admission and discharge along with corresponding MDS 3.0 data. For construct, we hypothesized that ROM scores would vary with age and discharge disposition. For responsiveness, we examined changes between admit and discharge scores using t-tests and ANCOVA.
Results: This study included 13,161 patient EMRs that reflected 9,650 (OT), 11,274 (PT), and 3,187 (ST) treatment episodes. There were significant gains between ROM admit and discharge scores (p = .001) in relationship to MDS change. ROM discriminated patients on the basis of age and discharge destination.
Conclusion(s): ROM is related to functional gain captured in the MDS and discharge destination. ROM demonstrates responsiveness, but its capacity to measure change over time requires further study. Future research should also evaluate relationship of ROM to hospital readmissions and community discharge to help inform therapists transition planning.
Implications: Policy is demanding standardization of post-acute rehabilitation instruments to evaluate outcomes across settings. The ROM is a valid measure of performance in SNFs that may can also be used to inform discharge planning.
Funding acknowledgements: None
Topic: Outcome measurement
Ethics approval: Rocky Mountain U of Health Professions
All authors, affiliations and abstracts have been published as submitted.
