Acute Care

doctor reviewing chart with elderly patient

The FIM® instrument was designed to assess disability and functional status, but a number of factors may complicate or prevent its use in an acute hospital setting. These include:

  • Illness severity
  • Short stays
  • Limited contact time with staff
  • Interruptions for diagnostic or therapeutic procedures
  • Lack of access, supplies, and/or space to assess motor or ADL items

UDSMR’s AcuteFIM® instrument is designed for use in acute care hospital settings and provides a reliable link to the FIM® instrument used in postacute care settings. The three-level, six-item AcuteFIM® instrument helps project the burden of care (i.e., the amount of help needed), total FIM® rating, and indicated discharge setting. This information can help guide clinicians in planning discharge placement options with, and communicating them to, postacute care clinicians.

The six items used in the AcuteFIM® instrument—four motor items and two cognitive items—were selected from the FIM® instrument for their practicality, as each is routinely addressed in the acute hospital setting. The items include Eating, Grooming, Bowel Management, Transfers: Toilet, Expression, and Memory. Due to familiarity with these items from the FIM® instrument and the three-level rating system—No Helper – Independent, Helper – Modified Dependence, and Helper – Complete Dependence—the AcuteFIM® instrument can easily be used by acute hospital staff across all disciplines. The link with the FIM® instrument also means measuring functional status at all levels in the continuum of care.

The AcuteFIM® instrument should be administered within the first three days of the acute stay. Multiple assessments can and should be conducted throughout the acute care stay, prior to discharge, in order to help predict appropriate placement and thereby lower readmission rates. The AcuteFIM® instrument can become part of the preadmission screening for patiens transferred to a rehabilitation program. Periodic comparisons of the projected and actual postacute discharge settings can also be useful in outcomes management.

Implementation of the AcuteFIM® instrument requires little setup time. Users are not required to load or maintain special software on their computers because the AcuteFIM® instrument is an Internet-based application and can be used in the latest version of any browser, including Internet Explorer, Google Chrome, Mozilla Firefox, and Apple Safari. Easy-to-complete assessment forms are entered online, and coding forms and comparison graphs can be printed immediately for internal use. Interfacing between the AcuteFIM® instrument and your facility's medical record documentation software is possible.