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Using Functional Independence Measure Subscales to Predict Falls-Rapid Assessment.

Benjamin Fusco-Gessick¹, Michele Cournan

¹Sunnyview Rehabilitation Hospital, Schenectady, NY, USA.

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|March 21, 2018

Summary

Inpatient falls risk can be predicted using early Functional Independence Measure (FIM) subscales. The Toileting and Expression subscales accurately identify patients at high risk for falls during rehabilitation.

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Area of Science:

Rehabilitation Medicine
Gerontology
Patient Safety

Background:

Falls are a significant challenge in inpatient rehabilitation settings.
Functional Independence Measure (FIM) scores are known predictors of falls risk.
Early assessment of falls risk is crucial for timely intervention.

Purpose of the Study:

To determine if early FIM subscales can predict falls in rehabilitation patients.
To develop a falls risk prediction metric using minimal, early-assessed FIM data.
To improve upon existing methods for identifying high-risk individuals.

Main Methods:

Retrospective cohort study utilizing two large patient samples (n=1,553 and n=12,301).
Selection of FIM subscales assessed earliest during admission, relevant to known falls risk factors.
Development and validation of a predictive metric using receiver operating characteristic curves.

Main Results:

A combination of the Toileting and Expression FIM subscales demonstrated strong predictive utility for falls.
This two-subscale metric performed comparably to the full FIM assessment.
The predictive performance exceeded existing falls risk assessment methods.

Conclusions:

Early assessment using specific FIM subscales can effectively predict inpatient falls.
The Toileting/Expression FIM metric offers a simple, rapid, and accurate method for falls risk assignment.
This approach can aid in proactive patient safety management during rehabilitation.