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FIM+FAM – OUTCOME MEASURES

FIM+FAM – OUTCOME MEASURES. Presented by Caroline Ray On behalf of Queen Elizabeth’s Foundation Brain Injury Centre, Banstead, Surrey. FIM+FAM: A BACKGROUND.

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FIM+FAM – OUTCOME MEASURES

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  1. FIM+FAM – OUTCOME MEASURES Presented by Caroline Ray On behalf of Queen Elizabeth’s Foundation Brain Injury Centre, Banstead, Surrey.

  2. FIM+FAM: A BACKGROUND • Functional assessment measures have been in use for half a century in rehabilitation to plan and evaluate care, determine compensation and predict prognosis. • The Barthel Scale (1965), commonly used by nursing staff measures activities such as: feeding, grooming, bathing, dressing, transfers and mobility but it does not address cognitive/social issues.

  3. FIM+FAM: A BACKGROUND • In the early 1980s an American task force took items from existing ‘physical’ scales and developed the Functional Independence Measure (FIM). • This was intended to create a global measure of disability but one which additionally addressed cognitive/psycho-social issues and which could be considered to be reliable regardless of clinical background of user.

  4. FIM+FAM: A BACKGROUND • The FIM is an 18 item measurement that evaluates a person’s functional status and abilities. Monitoring of scores therefore reflects progress and the clients discharge destination. • Functional Assessment Measure extends the coverage of the FIM and this scale was developed in the USA and adapted for the UK in 1993 (last modified in 1999).

  5. FIM+FAM UK: OUTCOME MEASURE • It adds an additional 12 items to the FIM which are around cognition and tests attention levels, problem solving, comprehension, expression, memory and social interaction, reading and writing skills and employability. • Status on admission, according to FIM+FAM scales, provides the clinical baselines and focus for treatment. It is recommended that the FIM+FAM is scored by a multi-disciplinary team, which improves inter-rated reliability.

  6. FIM+FAM: QEF BIC MODEL • Levels of dependency in activities of daily living, cognitive and communication, literacy and emotional adjustment are regularly assessed during the students rehabilitation and at discharge. • Assessment Scale runs from 1 - being the requirement of total assistance (the individual performs less that 25% of the task) to 7 - complete independence (the task is completed in a timely and safely manner).

  7. FIM+FAM: QEF BIC MODEL • Data collected clearly shows the progress that clients make during their rehabilitation from which valuable evidence can be extrapolated, for example: • 91% of clients have made progress in completing personal care, 100% have made progress with physical skills while a further 75% of clients have made progress with literacy and cognition.

  8. WHY MEASURE OUTCOMES? • To convince purchasers of services and demonstrate that rehabilitation is effective • To help direct therapies; identify which areas to work on • Encourage team communication and joint working • Data can be used to compare different services and client populations • Clearly demonstrate progress with physical and cognitive abilities and the subsequent reduced ‘burden of care’

  9. Further information • QEF, BIC Contact Head of Clinical Services – lynne.hensor@qef.org.uk • FIM/FAM training at Northwick Park Hospital, Harrow, Middx. Oct. 2011 cost £100 per person. FACS (AHSA) • Assessment to measure functional communication of adults with speech, language and cognitive communication disorders (including social communication, communication of daily needs, reading, writing, number concepts and daily planning.)

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