Quality of Care Measures for Inpatient Rehabilitation

The quality of care given to patients receiving medical rehabilitation at Cedars-Sinai is measured with a tool called the Functional Independence Measure (FIM). ™ Using this tool, rehabilitation specialists working with patients can measure their progress from admission through discharge. Often the type of patients admitted to the rehabilitation unit has sustained a catastrophic event or debilitating surgery or illness.

The FIM looks at 18 discrete functions of daily life to rate the patient's severity of disability and level of independence. Each functional item is rated on a seven-point scale. Scores can range from 18 (totally dependent) to 126 (totally independent). Areas rated include the patient's ability to care for him or herself, sphincter control, mobility, communication and social cognition. An interdisciplinary team at admission and again at discharge performs assessments to measure attainment of a patient's specific goals.

Medical rehabilitation facilities throughout the United States submit the data they collect using FIM to the Uniform Data System for Medical Rehabilitation in Buffalo, NY. National benchmarks for rehabilitation care are created using this data. In 2012, 850 organizations participated in the system, providing 433,107 patient records. Cedars-Sinai Inpatient Rehabilitation Program provided care to 762 patients in 2012. The data in the charts below reflects patients discharged between Jan. 1 and Dec. 31, 2012.

Cedars-Sinai Inpatient Rehabilitation unit is accredited by the Commission on Accreditation for Rehabilitation Facilities for the Comprehensive Integrated Inpatient Rehabilitation Program and the Stroke Specialty Program.

Profile of Patients Receiving Medical Rehabilitation at Cedars-Sinai

The first chart below compares the types of patients treated at Cedars-Sinai Medical Center with the types of patients treated at facilities nationally.

Medical Rehabilitation Patient Demographics
 Cedars-SinaiNationally
Average Age6669
Gender  
Male52%46%
Female48%54%

 

The following chart reflects the types of injuries or conditions that bring patients at Cedars-Sinai Medical Center to medical rehabilitation while they are in the hospital.

 

Length of Stay in the Hospital

Generally, the less time that a patient is required to stay in a hospital the better. Being able to leave a hospital sooner is an indicator of recovering better and faster.

The chart below compares the average length of stay experienced by inpatient rehabilitation patients at Cedars-Sinai compared to patients at medical rehabilitation facilities around the nation.

Life After Inpatient Medical Rehabilitation

The goal of medical rehabilitation is to improve the patient's independence in functional activities so that he or she can be as self-sufficient as possible. Signs that this goal has been reached include:

  • Being able to be discharged from the hospital
  • Improvements in the patients Functional Improvement Measure score
  • Still being able to live in the community 80 to 180 days after discharge from inpatient rehabilitation
  • The patient's perception of quality of life
  • Percentage of patients living 80 to 180 days after discharge

Discharge Rates for Medical Rehabilitation Patients

The chart below shows the percentage of patients at Cedars-Sinai who were discharged to their own homes or to board and care, retirement or assisted living facilities. This is compared with discharge rates on average nationally.

Functional Improvement

The chart below compares functional improvement scores measured at admission, discharge and 80 to 180 days after discharge for patients treated at Cedars-Sinai. This information is compared to national averages.

At Cedars-Sinai, patients on average were admitted with a functional improvement score of 63.7. This indicates that patients needed a moderate level of assistance.

Overall at discharge, Cedars-Sinai patients on average had a functional score of 87.5. This shows that patients needed minimal assistance when they were discharged.

At the time of follow-up 80 to 180 days after discharge, Cedars-Sinai patients had an average functional improvement score of 111.2. This indicated that the patients were independent with either an assistive device (such as a cane or walker) or needed additional time to complete activities.

Survival Rates After Discharge

A total of 95.4% percent of Cedars-Sinai inpatient medical rehabilitation patients were still living 80 to 180 days after discharge, compared to 93.4% of patients nationally.

Patient Status 80 to 180 Days After Discharge

Of the patients who were still alive upon followup, 96.4% of Cedars-Sinai inpatient medical rehabilitation patients were still living in the community 80 to 180 days after discharge. By comparison, nationally 92.6% of patients who had received inpatient medical rehabilitation were living in the community 80 to 180 days after discharge.

 

Patient Perceptions of Quality of Life After Discharge

When asked to rate their quality of life, patients who had received inpatient medical rehabilitation at Cedars-Sinai rated their quality of life at 3.4 on the scale. On average nationally, patients rated their perceived quality of life at 3.4.

Scale: 1 - Not applicable; 2 - Strongly disagree; 3 - Somewhat disagree; 4 - Somewhat agree; or 5 - Strongly agree.