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The AbilityQuotient: Impact of Utilizing a Patient-Specific Composite Rehabilitation Outcome Score on Patient
James A Sliwa1, Julia Carpenter2, Andrew Bodine2
1Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL; University for the Shirley Ryan AbilityLab, Chicago, IL.
Objective:
To describe the impact of utilizing a composite rehabilitation outcome score (cROS), the AbilityQuotient (AQ), on patient outcomes.
Design:
Observational convenience sample of interrupted time series data with independent groups defined by discharge year. Study included all adults admitted to an inpatient rehabilitation hospital pre- and postimplementation of the AQ.
Setting:
Inpatient rehabilitation hospital.
Participants:
A total of 13,397 inpatients admitted from calendar years 2019-2023.
Intervention:
Incorporation of the AQ into clinical decision making during team conferences.
Main Outcome Measures:
Mobility and Self-Care Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) Form GG change scores, and length of stay pre- and post-AQ implementation.
Results:
Post-AQ implementation, the IRF-PAI Form GG mobility score rose by 6.64 points, self-care score increased by 2.28 points, and length of stay decreased by ∼2.3 days (natural log of length-of-stay decreased by 0.10 ln-days). All changes in years 2021-2023 were significantly different from values measured in 2019, before AQ implementation.
Conclusions:
Incorporation of the AQ was associated with improved functional outcomes and reduced length of stay. Thus, this study demonstrates that a cROS such as the AQ, integrated into clinical workflows, represents a potential step toward precision rehabilitation and value-based care.
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