This paper will present the review process, describe in more detail eight assessments that fulfilled many of the review criteria, discuss the limitations of these measures using the "Guidelines for the Client-centred Practice of Occupational Therapy as the framework, and make recommendations for the development of a new outcome measure for use . Purpose. In all six settings, OT students provided ADL training (bathing/showering, toileting and toilet hygiene, dressing, functional mobility, personal hygiene and grooming). International Journal of Therapy and Rehabilitation, 12(8), 340-346. Chou, C. Y., Chien, C. W., Hsueh, I.P., Sheu, C.F., Wang, C.H., & Hseih, C.L. 1-844-355-ABLE. Thanks for helping us invest in our patients. Unsworth, C.A., & Duncombe, D. (2014). Standardized outcome tools assist with preventing hospital readmissions in acute care and aid in safe and effective discharge planning (Hoyer, et al., 2014). victoria principal andy gibb; bosch battery charger flashing green light Two settings recorded only baseline evaluations and one recorded only the baseline goals. Perry, A., Morris, M., Unsworth, C., Duckett, S., Skeat, J., Dodd, K., Taylor, N. & Riley, K. (2004). Methods: Fort Collins, Colorado: Three Star Press, Inc. Fingerhut, P., Madill, H., Darrah, J., Hodge, M. & Warren, S. (2002). Copyright 2023 Royal College of Occupational Therapists. 1 by U.S. News & World Report for 31st Consecutive Year, Community-Ready Upper Extremity Interactive Rehabilitation, Dr. Lieber To Receive AACPDM's Lifetime Achievement Award for Research on Cerebral Palsy, Global Advisory Services Hospital Training & Consulting, Medical Student Education & Residency Program, Bundled Webinars: Spinal Cord Injury (3 Titles), 1 Year Webinar Package - Unlimited Access, Australian Therapy Outcome Measures for Occupational Therapy, Making Waves Following a Spinal Cord Injury, Full Circle After a Non-Traumatic Brain Injury, An Unanticipated Head Injury and Incredibly Bright Future, Parkinson's Disease & Neurologic Rehabilitation. Assessment and outcome measurement goals for effective practice. Applying concepts of levels of measurement to your own practice. Bachelor's or Master's degree from a regionally accredited institution. Clinical judgement and clinical reasoning. Self-Care-Participation/Restriction: Fristedt (2013) reported ICCs between .58 and .93 for the Intrarater reliability of the 15 raters across the case studies, for the 12 AusTOMs scales. An Outcome Measure is the result of a test that is used to objectively determine the baseline function of a patient at the beginning of treatment. Your gift of Ability affects everythingwe do every day at Shirley Ryan AbilityLab from the highest-quality clinical care and groundbreaking research to community programs that improve quality of life. Bjorkdahl, A., Nilsson, A. L., Grimby, G. & Sunnerhagen, K. S. (2006). 4. one-way relationship. Enter your zip code . Factors impacting the use of outcome measures were identified as: 1) challenges selecting the appropriate outcome measure; 2) too time consuming for patients to complete and difficult to complete independently; 3) short length of stay; 4) limited time for therapists to complete the evaluation; 5) fast-paced and dynamic environment (different floors, different teams/members); 6) timing problems where patients undergoing tests/procedures were off the floor; 7) and patients were medically unstable at the time of the attempted/scheduled evaluation. The skills are consistent with the goal-directed actions defined under the Activities and Participation domains of the International Classification of Functioning, Disability and Health. Chapter 4: Levels of measurement (Alison Laver Fawcett, PhD, DipCOT). You can also join our Rehabilitation Measures Database Networking Group on LinkedIn by . 2. no feedback given to client. No significant correlation in comparison of the amount of change detected by each instrument. official website and that any information you provide is encrypted An ethnographic study indicated that non-standardized functional-based outcome measures are the most frequently used method in discharge assessment with inconsistency in the use of standardized tools at acute care settings (Crennan & MacRae, 2010). British Journal of Occupational Therapy, 77(2), 44-49. The 20 ADL process skill items are divided into 5 domains (Sustaining Performance, Applying Knowledge, Temporal Organization, Organizing Space and Objects, Adapting Performance), Item-level scores range from 1 = No Problem to 6 = Inordinate; cannot test, The AMPS is administered in four phases. 1-844-355-ABLE. Administration instructions are detailed in the manual available on the website. doi:10.1371/journal.pone.0147980. Validity of the AusTOM Scales:A comparison of the AusTOMs and EuroQol-5D. Chapter 3: Purposes of assessment and measurement (Alison Laver Fawcett, PhD, DipCOT and Karen Innes, BSc OT, DMS, Cert Counselling). However, our students were asked to use at least the outcome measures being used at the acute care hospitals they were at, and they worked closed with the OTs working there to make sure the data collected were accurate enough. In January 2017, MSN Money listed occupational therapy as one of the 25 best jobs in America right now. Cross-Cultural Validation of Health and Quality of Life Measures for Children in Hong Kong. Sze HLH, Fung CLB, Cheung PPP, Chim TYA, Lee MH, Law CCC, Lau WMB. Pleasee-mail us! The .gov means its official. Needs assessment - considering wider populations. Main Outcome Measures: Not applicable. Extracurricular and interpersonal life experiences. Change from admission to discharge for clients, Using Wilcoxon Signed Ranks Test, all significant, p<.001, for mixed client population including: Abu-Awad, Y., Unsworth, C.A., Coulson, M., & Sarigiannis, M. (2014). (2013). Case example: James Assessment of Motor and Process Skills (AMPS) report by Rachel Hargreaves. Developed in Australia and is now used internationally (e.g. Archives of Physical Medicine and Rehabilitation, 75(8), 843-851. doi: 10.1016/0003-9993(94)90107-4, Doble, S.E., Lewis, N., Fisk, J.D., & Rockwood, K. (1999). The nature of human function and the complexity of measuring functional outcomes. American Journal of Occupational Therapy, 65(6), 643650. Assessment is fundamental to effective occupational therapy practice. Occupational Therapy Journal of Research, 22(2), 8292. The results on their utility from this study were mixed but the general consensus was that although quick and easy to administer, the selected outcome measures did not help with discharge decision making or discharge planning. Care-giver and parent burden scales). Introduction. 77- 81). This is partially supported by our data that some of the facilities were unfamiliar with many standardized tools. An ethnographic study indicated that non-standardized functional-based outcome measures are the most frequently used method in discharge assessment with inconsistency in the use of standardized tools at acute care settings (Crennan & MacRae, 2010). Wades (1988) 4-level model for people with stroke. Applying concepts of validity to your own practice. Health and Quality of Life Outcomes, 2, 64-75. 1-844-355-ABLE. Scott, F., Unsworth, C.A., Fricke, J., Taylor, N. (2006). A cluster randomised controlled trial on the efficacy of client-centred occupational therapy in multiple sclerosis: good process, poor outcome. The nature of occupational therapy practice in acute physical care settings. Case study: service evaluation - The Development and initial evaluation of a Memory Activity and Self Help (MASH) Group by Karen Innes and Alison Laver Fawcett. There are some limitations to this study. In January 2018, U.S. News & World Report ranked occupational therapy is 11th of the 100 best jobs for 2018. Initial review and summary completed by Amanda Timmer and Carolyn Unsworth. To avoid variations in care and show the value of therapy services, ensure your rehabilitation therapists are using standardized outcome measures . Journal of the American Geriatrics Society, 44(11), 1342-1347. Occupational therapy discharge assessment of elderly patients from acute care hospitals. FOIA The importance of the selection and application of terminology in practice. al, 2002; n = 42; Age Range 5 7; Kindergarten students from five public schools), Children with No Known Disabilities: (Peny-Dahlstrand, Gosman-Hedstrom & Krumlinde-Sundholm, 2010), Developmental Delays (Kang et al., 2008; n = 33; Mean Age = 6.1 (1.9) years; Korean sample), Children With or Without Mild Disabilities: (Gantschnig, Page, Nilsson & Fisher, 2013; n = 10,998; Mean Age = 8.7 (3.2) years; Sample selected from the international AMPS database), Excellent significance between two groups in mean ADL process ability measures (p < .001, t = -4.296), Children with No Known Disabilities (Poulson, 1996; n = 162), Goodness of fit; 90% to AMPS-M, 95% to AMPS-P, Children With or Without Mild Disabilities: (Gantschnig, Page, Nilsson & Fisher, 2013), Big Change (Cohens d = 0.81 to 0.98) for 12-15 year olds in ADL motor ability, Big Change (Cohens d = 0.83 to 1.26) for 6-15 year olds in ADL process ability, Children with No Known Disabilities: (Peny-Dahlstrand, Gosman-Hedstrom & Krumlinde-Sundholm, 2012; n = 4613; Age Range 3-15 years; Subset of the AMPS Project International Database, North American (n = 2239) and Nordic (n = 2374) children ), Community Dwelling Adults (Merritt, 2011; n = 38,540, Randomly-selected subset of AMPS Project International database), Mixed Population: (Gantschnig, Page & Fisher, 2012; n = 145489; Mean Age = 54.06 (24.43) years; Sample from the international AMPS database), Mixed Population: (Fisher & Jones, 2012; n = 148158; Age Range = 3 - 103; Sample from international AMPS database), Community-Dwelling: (Goto, Fisher & Mayberry, 1996; n = 10; Mean Age = 28.9 (3.98) years; Mean time living in United States = 12.4 (8.8) months; Japanese sample living in the United States for less than 3 years), Community-Dwelling: (Fisher, Liu, Velozo & Pan, 1992; n = 20; Mean Age = 28.5 (3.32) years; Non-disabled Taiwanese sample living in United States for less than 3 years), Mixed Population: (Fisher & Jones, 2012), Community Dwelling Adults (Merritt, 2011), Mixed Population: (Gantschnig, Page & Fisher, 2012), Multiple Sclerosis: (Doble et al., 1994; n = 44Mean Age = 44.5 (12.3) years, Mean Duration of Self-Reported MS = 19.9 (12.4) years), Atchinson, B., Fisher, A. Hoyer, E.H., Needham, D.M., Atanelov, L., Knox, B., Friedman, M., & Brotman, D.J. Exploring the literature for examples of tests and test critiques. Pearson product-moment correlation coefficient. Dysarthria is a collective term referring to a group of movement disorders affecting the muscular control of speech. The influence of the level of task demand. Reliability of the Australian Therapy Outcome Measures for quantifying disability and health. Only three settings documented both baseline and final outcome measurement data. Two settings completed only baseline evaluations and one recorded only the baseline goals. Unsworth, C.A., & Duncombe, D. (2005b). A qualitative study of clinical decision making in recommending discharge placement from the acute care setting. The demand for robust clinical governance. Scores in outcome measures. General systems theory and the hierarchy of living systems. Royal College of Occupational Therapists A scoping review of the patient's perspective. Domestic life- inside house 9. (1996). Dysarthria affects the ability of individuals to . The https:// ensures that you are connecting to the Australian Occupational Therapy Journal, 60(1), 3-19. doi:10.1111/1440-1630.12024. Out of the 32 second year OT students, seven of them completed fieldwork at six acute inpatient hospital settings providing OT for 205 patients, including 99 male and 106 female patients with an average age of 63.2915.86. Outcomes are established using assessment tools and outcome performance measures. Carrying out daily life tasks and routines 5. Scandinavian Journal of Occupational Therapy, 6(3), 111-118. doi:10.1080/110381299443690, Haslam, J., Pepin, G., Bourbonnais, R., & Grignon, S. (2010). Courses with a "C-"or lower are not . International Classification of Impairment, Disability and Handicap. Even when used, there is significant variability in the use, and scarce research is available on the optimal tool to be used by OTs at acute care settings. Fristedt, S., Elgmark, E. & Unsworth, C.A. EBRSR Review by ICF Description of the therapy diagnosis / problem. . Unsworth, C.A. No significant correlation for changes in FIM motor scores changes detected using the AMPS motor scale (, No significant correlation for changes detected by the FIM cognitive scale and those detected by the AMPS process scale (, No ceiling effects found for the AMPS motor and process scales. Process of task performance as measured by the Assessment of Motor and Process Skills (AMPS): A predictor of work-related outcomes or adults with schizophrenia? The relationship between the Assessment of Motor and Process Skills (AMPS) and the Large Cognitive Level (LACL) test in clients with stroke. ADL motor skills are observed when an object is moved or when one moves oneself. Become an occupational therapist brochure, Tips for your occupational therapy application, Degree Level Apprenticeship in Occupational Therapy, Join World Federation of Occupational Therapists (WFOT), Tax relief and insurance for RCOT members, Senior leadership team and member get togethers, RCOT SS - Children, Young People and Families, Becoming an independent practitioner (member stories), RCOT SS - People with Learning Disabilities, RCOT SS - Trauma and Musculoskeletal Health, NHS issues advice for private practitioners wanting to return to work in the NHS, Preparing your child for returning to school, Practice placements crucial for sustaining the workforce supply pipeline, Recovering from COVID-19: Post-viral fatigue and conserving energy guides, Preparing for a return to school - how occupational therapists can help, RCOT supporting and safeguarding members returning to work during the pandemic, Scope of practice things to consider during COVID-19, Your health and wellbeing during the COVID-19 crisis, Joint call for Personal Protective Equipment for AHPs and Social Care, Financial support announced for self-employed, Emergency Bill to strengthen COVID-19 response plans becomes law, Government issues ethical framework for Adult Social Cares response to COVID 19, Inspire future occupational therapists: #ChooseOT, Professional practice enquiries service - FAQs, American Journal of Occupational Therapy (AJOT), Australian Occupational Therapy Journal (AOTJ), Canadian Journal of Occupational Therapy (CJOT). What is important to patients in palliative care? This is a dummy description. The AMPS is designed to examine interplay between the person, the ADL task and the environment. Assessments form an integral component in the occupational therapy process. Scale 7. International Journal of Health Sciences and Research, 5 (8), 369-376. They generate numerical data which can be Client-centred occupational therapy in Canada: refocusing on core values. To be considered relevant, difference should exceed + 1.96 SEM. and transmitted securely. Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. Cultural issues and self-report data collection. The aim of this study was to identify the outcome measures used by OTs in acute inpatient hospital settings and to explore factors that impact the use of outcome measures. Using a semi-structured interview, the COPM is a five step process which measures individual, client-identified problem areas in daily function. Therapy Outcome Measures for Allied Health Practitioners in Australia: The AusTOMs. OTs agree that they were unfamiliar with any standardized outcome measurement currently available that addressed the diversity of patients in acute care. OTs use outcome measurements in different settings to help inform colleagues and other medical professionals of the complexity of the patients diagnosis, increase effectiveness, and improve patient outcomes. VT-ART delivers focused, high-dose radiation, usually in a single fraction of 25 Gy, allowing . The American Journal of Occupational Therapy, 50(10): 798-806. doi: 10.5014/ajot.50.10.798, Hartman, M., Fisher, A., & Duran, L. (1999). AOTA (2017), Occupational Therapys Role in Acute Care, AOTA Fact Sheet, Retrieved https://www.aota.org/-/media/corporate/files/aboutot/professionals/whatisot/rdp/facts/acute-care.pdf. AusTOMs for Occupational Therapy. . A scope review paper found that OTs are often time poor and within a right time frame are unable to extend their services to provide full intervention and to use currently available outcome measures necessary for the patients (Britton, et al., 2015). Chapter 1: The importance of accurate assessment and outcome measurement (Alison Laver Fawcett, PhD, DipCOT). The use of outcome measures to demonstrate changes in patient's functional ability as well as evaluating service effectiveness is crucial for the profession to work in an evidence based practice manner. Examples of assessments that use information from a proxy. The SEM has been calculated for 2 scales, from the data from Fristedt (2013) with 15 therapists rating 6 cases for Scale 7 (Self-Care), and 3 cases for Scale 5 (Transfers). Self-Care with 7 OTs rating 15 client case studies with a range of conditions including: stroke, acquired brain injury, arthritis, spinal cord injury, amputation, schizophrenia, depression, dementia, Parkinsons Disease, burns and cerebral palsy. Conclusions: . In all six acute settings, OT students provided activities of daily living (ADL) training (bathing/showering, toileting and toilet hygiene, dressing, functional mobility, personal hygiene and grooming). Unsworth, C.A., & Duncombe, D. (2014). More importantly, therapists questioned applicability of the tools to the acute care setting where they would have to be administered bedside to patients who were often critically ill, vulnerable, or not feeling or performing at their best. Canadian Journal of Occupational Therapy, 79(3), 167-174. https://doi.org/10.2182/cjot.2012.79.3.6, Gantschnig, B.E., Page, J., & Fisher, A.G. (2012). The short time period and the novice skills of our students may have influenced the quality of data collected. volume 1: development, standardization, and administration manual, volume 1. Archives of Physical Medicine and Rehabilitation, 78(12), 1309-1315. doi: 10.1016/S0003-9993(97)90302-6, Pan, A. Glassdoor ranked occupational therapy as 4th among the 50 best jobs in America in 2018. However, acute care OTs are not using them but rather relying on skilled observation of functional performance. PMC Strokespecific executive function assessment: A literature review of performancebased tools. OT Practice Free Occupational Therapy Assessment Tools by Category February 19, 2021 Contents Hide 1 Cognition 2 ADLs 3 IADLs 4 Sleep 5 Health Management 6 Apraxia Cognition Kettle Test Short-Blessed Test Confusion Assessment Method (CAM) Mini-Mental State Examination (MMSE) Glasgow Coma Scale Saint Louis University Mental Status (SLUMS) ADLs Our students and their OT mentors share this interest during the fieldwork. (2008). Topics in Stroke Rehabilitation, 15(4), 351- 364. Journal of Applied Gerontology, 29(4), 494506. By not using standardized outcome measurement tools, the value and benefits of OT services such as ADL and IADL training, patient and caregiver education, and training to use adapted equipment/assistive devices is anecdotal at best. Further research is needed to identify common outcome measures suited for use by OTs in acute inpatient hospital settings. OTs need easy access to information about the clinical utility and psychometric qualities of various measures to help with the appropriate selection and clinical applicability of standardized tools to measure functional outcomes in acute inpatient hospital practice. Five outcome measures were used by the students: modified Functional Independence Measure (two settings), the Functional Independence Measure (one setting), the Boston University 6 click AM-PAC (one setting), the Canadian Occupational Performance Measure (one setting), and self-reported goals by patients (one setting). Bookshelf Older adults were defined as being 70 years or older to reflect the increase in life expectancy in western countries [ 15 ]. Students recorded a range of individual characteristics (e.g., age, gender, race, educational level, and diagnosis) and length of stay into an Excel database. British Journal of Occupational Therapy, 59(6), 260-263. doi:10.1177/030802269605900603, Wales, K., Clemson, L., Lannin, N., & Cameron, I. Unauthorized use of these marks is strictly prohibited. There is no one standardized tool currently available that is comprehensive enough for the acute care setting. A clear conceptualisation of QOL that incorporates occupational therapy values such as client-centredness and holism is needed to advocate for the profession's role in health care and to encourage the development of suitable outcome measures. (1993). Conclusion: achieving an effective and efficient assessment. Fisher, A. G. & Jones, K. B. demonstrate change (if any) resulting from. Arksey, H. & O'Malley, L. (2005). 4308 . The Royal College of Occupational Therapists (or 'RCOT') is a registered charity in England and Wales (275119) and in Scotland (SCO39573) and a company registered in England (No. (2010). Labels used for providers and recipients of therapy services. In Australian Institute of Health and Welfare, ICF Australian user guide. . Author(s) Disclosures: No disclosures. "This book provides a comprehensive guide to the background, rationale and utilization of assessment and outcome measurement. Does a short period of rehabilitation in the home setting facilitate functioning after stroke? What's Transparent Peer Review and How Can it Benefit You? A change of .5 to 1 point on any of the 4 domains of the AusTOMs-OT scale is considered clinically important. (2014). Clinical reasoning as an essential component of practice. The wide use of this measure is consistent with earlier studies specific to cognitive impairments [ 11] as well as other general occupational therapy assessments [ 12 ]. No. The Need for Entrepreneurship in Sustainable Chemistry. British Journal of Occupational Therapy, 68(8), 354- 366. Differences between persons with right or left cerebral vascular accident on the Assessment of Motor and Process. More occupational therapy practitioners are using standardized assessments than previous noted in research. The AMPS assesses the quality of the persons ADL performance by rating the effort, efficiency, safety, and independence of 16 ADL motor and 20 ADL process skill items. BAYLEY SCALES OF INFANT DEVELOPMENT (BSID) The Canadian Occupational Performance Measure (COPM) was the most widely used assessment, where 56.7% of our respondents reported using the COPM. Follow us on Facebook @rehaboutcomes and Twitter @rehab_outcomes for more information about the Rehabilitation Measure Database and our other grants at the Center for Rehabilitation Outcomes Research. Self-Care and Scale 5 (Transfers) with 7 OTs rating 6 or 3 cases (respectively) with a range of conditions including: spinal cord injury, amputation, schizophrenia, hip replacement, muscle disease, and cancer. Crennan, M., & MacRae, A. Rehabilitation of anterior pituitary dysfunction combined with extrapontine myelinolysis: A case report. Outcome measures can be used to evaluate the effectiveness of our interventions and services by identifying whether change has occurred over time. self-report, proxy) for collecting information about clients are then reviewed, and the main purposes of assessment (e.g. Epub 2017 Sep 22. By not using standardized outcome measurement tools, the value and benefits of OT services, such as ADL and IADL training, patient and caregiver education, and training to use adapted equipment/assistive devices is anecdotal at best. Further research is needed to identify or develop outcome measures suited for use by OTs in acute inpatient hospital settings. The Assessment of Motor and Process Skills Applied Cross Culturally to the Japanese. Keywords: tested for validity and reliability. Reliability coefficients and standard error of measurement. OTs use standardized outcome tools in different settings to help inform colleagues and other medical professionals of the complexity of the patients diagnosis and functional level and to aid in safe and effective discharge planning. Implementation of evidence-based practice. Aaronson, N., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A. Duez, N. et al. Typically outcome measures have a scoring system. Alison Laver-Fawcett, PhD, OT(C)), DipCOT, SROT currently Modernisation Manager, Service Development (Provider Services) and Interim Professional Lead for Occupational Therapy, North Yorkshire and York Primary Care Trust. Summary of the results other team members assessments. The impact of familiarity on performance. Aikat, R. & Gomes, O. (1995). Reflecting on purposes of assessment in your own practice. The AusTOMs-OT is a measure ofglobal functional outcomes for clients of all ages, all diagnoses and in all settings. AusTOMs for Occupational Therapy. This site needs JavaScript to work properly. Fristedt (2013) studied Scale 7. The COPM is an outcome measure designed for use by occupational therapists to assess client outcomes in the areas of self-care, productivity and leisure. Toll-Free U.S. Chapter 2: Methods of assessment and sources of assessment data(Alison Laver Fawcett, PhD, DipCOT, Sally Payne, MSc, BSc, DipCOT and Claire Howell, BScOT (Hons)). PloS One, 11(2), e0147980. International Journal for Quality in Health Care, 16(4), 285- 291. Must be earned at a "C" or above. Can J Occup Ther. Classroom-based assessment: Validation for the School AMPS. https://doi.org/10.3109/11038121003615327, https://doi.org/10.1080/1364557032000119616. The smallest observable action of an occupation performed is called performance skills. Unsworth, C.A., & Duncombe, D. (2011). Clinical Rehabilitation, 20(12), 10381049. The average length of stay was 6.607.43 days. As a means of improving this process, previous research reported that OTs were interested in finding ways to use standardized outcome measures to help guide discharge decision making (Jette, et al., 2003; Robertson & Blaga, 2013; Smith-Gabai, 2016). New Zealand Journal of Occupational Therapy, 55(2), 11-18. The assessment of process and motor skills of persons with psychiatric disorders. Skeat, J., Perry, A., Morris, M., Unsworth, C., Duckett, S., Dodd, K., Taylor, N. (2003). ; The EORTC Quality of Life Group. A survey study on 72 OTs working in acute care settings in New Zealand reported similar results that the majority of outcome measures used are non-standardized and include both subjective interview and observations of the patient carrying out functional tasks (Robertson & Blaga, 2014). Assessing the ADL functioning of persons with Alzheimers disease: Comparison of family informants rating and performance-based assessment findings. Factors that impact the use of outcome measures include: challenges selecting the appropriate outcome measure; too time consuming for patients to complete and difficult to complete independently, short length of stay, limited time for therapists to complete the evaluation, fast-paced and dynamic environment (different floors, different teams/members), timing problems where patients undergoing tests/procedures were off the floor, and patients were medically unstable at the time of the attempted/scheduled evaluation. Only three settings documented both baseline and discharge outcome measurement data. AM-PAC "6-Clicks" functional assessment scores predict acute care hospital discharge destination. Eighteen publications met the inclusion criteria. A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 76, 1144-1151. doi: 10.1016/S0003-9993(95)80124-3. Example reviews and critiques in journal articles. Multi-disciplinary team meeting with Carol.