Capturing Functional Independence Measure (FIM) Ratings
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2015-05
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[Honolulu] : [University of Hawaii at Manoa], [May 2015]
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Abstract
The FIM® rating system is an important quality measure for rehabilitation facilities and units as it is the only admission patient information that directly impacts reimbursement for care delivery. Past practice at the project site dictated that FIM® ratings were collected on day two or three of admission which allowed ample time for patients to rest but delayed the collection of FIM® ratings. This scholarly inquiry project (SIP) challenged the delay in collection of admission FIM® ratings and developed innovations to assess FIM® ratings on the day of admission.
An administrative FIM® quality improvement team was established to guide this project and was identified as the primary stakeholder with the goal to improve quality care and reimbursement. The project was designed to improve FIM® rating assessments on the day of admission.
The innovations included in this SIP were the establishment of the FIM® team, nursing staff training on early capture of FIM® ratings, and the development of an electronic FIM® recording template. These innovations were shown to be successful in changing practice to capture FIM® ratings immediately upon admission. This SIP was implemented and evaluated in just under one year and included the efforts of multiple RHOP staff members dedicated to improving the quality of care. Overall this SIP is considered to be successful with six of the seven objectives being met. The last objective demonstrated an increase in reimbursement but not enough to exceed the predicted margin to count the objective as being met.
As FIM® ratings were captured earlier upon admission the data demonstrated that lower FIM® ratings were documented and resulted in lower overall admission FIM® ratings in 2014 as compared to 2012. In addition to practice changes and FIM® training, creating the FIM® team was an essential innovation as the team prioritized the capture of FIM® ratings immediately upon admission. FIM® data collected pre and post innovation demonstrated that early capture of FIM® ratings is essential to provide quality care and accurately estimate length of stay.
Description
D.N.P. University of Hawaii at Manoa 2015.
Includes bibliographical references.
Includes bibliographical references.
Keywords
Nursing, FIM, Rehabilitation Facilities, Scholarly Inquiry Project
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Theses for the degree of Doctor of Nursing Practice (University of Hawaii at Manoa). Nursing
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