Leading the Charge for Quality Patient Care: Standardized Assessments, the Lemon Grove Care and Rehab Way

Leading the Charge for Quality Patient Care: Standardized Assessments, the Lemon Grove Care and Rehab Way

           

It was not too long ago that the therapy team at Lemon Grove Care and Rehabilitation (LGCR) created and implemented a community reintegration program.  That program continues to be a success but the therapy team is constantly pushing the boundaries for quality patient care.  Recently, the therapy team has decided to focus their efforts on improving evaluations and assessments.  After an analysis of trends in the rehab world and a self-reflection of the therapy process at LGCR, the therapy team decided that they need to expand their use of standardized assessments. 

Standardized assessments are not used frequently in many facilities possibly because of the notion that these tests take too long to conduct and score.  However, therapists at LGCR have found that certain tests only take 10 to 20 minutes to complete, score, and analyze.  Therapists at LGCR are opting to use standardized assessment more often as these instruments contain instructions for a formal and uniform method of administering the test and scoring the results, yield standardized results, includes normative referenced or criterion referenced data, and have been tested for psychometric rigor.  Results from standardized tests can be compared over time to accurately track progression and to assist therapists with documenting, updating changes to a plan of care, or for making recommendations for discharge.

 LGCR’s physical therapists assess patients using standardized tests including the Tinetti Balance Assessment Tool, Timed Up and Go test, and the Berg Balance Scale.  The Tinetti Balance Assessment Tool contains test items examining a patient’s balance and gait.  Scores from the Tinetti Balance Assessment Tool indicate whether the patient has low, medium or high risk of falls.  Physical therapists can use the results to confidently issue a walker to a patient to use independently in their room or to justify the necessity of continued skilled therapy. 

Huy Dinh OTR/L and Tara Zimmerman,

Physical Therapy Student, conducting the

Tinetti Balance Assessment Tool.

LGCR’s occupational therapists focus on assessing patient’s performance in activities of daily living (ADL) using the Barthel Index of Activities of Daily Living. This instrument measures patients’ level of disability and independence with self care. Occupational therapists can write a custom goal in Rehab Optima to set a target and routinely measure progress. Additionally, the occupational therapy team is working on setting up a cognitive rehabilitation program which will incorporate the Allen Cognitive Level Screen. This tool will help therapists assess a patient’s cognitive function, and learning potential. Results from this assessment can guide intervention, assist therapists in making recommendations to ensure safety, justify necessity for skilled services at a nursing facility, and make discharge plans.

Ann-Marie Hulse, speech therapist and director of rehab at LGCR, has routinely used the Mini Mental Status Exam (MMSE) and the St. Louis University Mental Status (SLUMS) test to evaluate a client’s cognitive skills. The MMSE, the more popular test between the two, measures patients’ level of cognitive impairment, and assist clinicians to determine the severity of Alzheimer’s disease and track its progression. Results from the MMSE helps Ann-Marie make accurate recommendations for potential discharge locations and support services to patients, family members and social services staff which ensures a safe transition from a skilled nursing facility to home with adequate support.

Excellent customer service and quality skilled therapy are the hallmarks of LGCR, so therapists at this facility plan to continue increasing their use of standardized assessments and train students and other therapists in incorporating these instruments into their evaluation process.  The therapists agree that patients, family members, doctors, and insurance providers receive more accurate patient-related information and evidenced-based recommendations when standardized assessments are used in a patient’s plan of care.