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.
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Huy Dinh OTR/L and Tara Zimmerman,
Physical Therapy Student,
conducting the
Tinetti Balance Assessment Tool.
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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.
