FIM stands for Functional Independence Measure, an assessment tool doctors, therapists, and nurses use during rehabilitation and physical therapy.
What does FIM stand for in physical therapy?
- What is FIM? FIM stands for Functional Independence Measure, an assessment tool doctors, therapists, and nurses use during rehabilitation and physical therapy. FIM gauges and track the amount of assistance that a person may require to carry out everyday activities.
- 1 What is FIM scores in physical therapy?
- 2 What is FIM healthcare?
- 3 What is FIM training?
- 4 What is FIM nursing?
- 5 What is a good FIM score?
- 6 Is the FIM a standardized test?
- 7 What is a FIM assessment?
- 8 What are the 5 levels of assistance?
- 9 What replaced the FIM?
- 10 What is a FIM Group?
- 11 How long does the FIM take to administer?
- 12 Who created the FIM?
- 13 What is burden of care and how does it relate to the FIM?
- 14 Why is functional independence important?
- 15 How do you achieve functional independence?
- 16 Functional Independence Measure (FIM)
- 17 Intended Population
- 18 Method of Use
- 19 Reliability and Validity
- 20 References
- 21 What does FIM stand for in rehab?
- 22 What does FIM stand for in rehab? – Related Questions
- 22.1 What replaced FIM?
- 22.2 What training do you need to administer FIM?
- 22.3 Is FIM a self report?
- 22.4 How do you score FIM?
- 22.5 How do I get FIM certified?
- 22.6 Is the FIM still used?
- 22.7 What is a FIM assessment?
- 22.8 Is FIM standardized?
- 22.9 What is considered modified independence?
- 22.10 What is level of independence?
- 22.11 What is the 60 rule requirement?
- 22.12 What is a PPS coordinator?
- 22.13 What is an IRF Pai?
- 22.14 What is meant by functional independence?
- 22.15 What is the functional independence measure for children?
- 22.16 Who created FIM?
- 22.17 What is FIM instrument?
- 22.18 What does functional mobility mean?
- 22.19 What does stand by assistance mean?
- 22.20 What is ECE helmet rating?
- 23 The Role of the FIM in Physical Therapy
- 24 Parts of the FIM
- 25 A Word From Verywell
- 26 CARE Item Set / Section GG for ARU Inpatient Rehab (vs FIM) Revisited – OT Dude
- 27 FIM-score predictors of discharge destination in older patients admitted for inpatient rehabilitation
- 28 What does the FIM stand for?
- 29 FIM(TM)
- 30 Functional Independence Measure
- 31 King’s College London – FIM+FAM
- 32 FIM / WeeFIM – University of Wollongong – UOW
- 33 Learn more about the FIM / WeeFIM
What is FIM scores in physical therapy?
The Functional Independence Measure (FIM)31 is a widely accepted functional assessment measure used during inpatient rehabilitation. The FIM is an 18-item ordinal scale, used with all diagnoses within a rehabilitation population. FIM scores range from 1 to 7 (1 = total assist and 7 = complete independence).
What is FIM healthcare?
The Functional Independence Measurement (FIM) is an outcome measurement tool used by physical therapists and other healthcare professionals to measure overall independence during specific functional tasks.
What is FIM training?
The FIM and WeeFIM instrument assesses self-care, sphincter control, transfers, locomotion, communication and social cognition on a seven-level scale. After training, to become credentialed, eligible participants are required to sit a credentialing examination.
What is FIM nursing?
Objectives: To determine which dimensions of functional independence measure (FIM) scores or patient characteristics were associated with the possibilities of returning home or being admitted to a nursing home.
What is a good FIM score?
People with a total FIM score between 100 and 110 require minimal assistance with their day-to-day activities. Additionally, the difference between your initial FIM score and your score at discharge is also a good indicator of progress you’ve made during your rehabilitation period.
Is the FIM a standardized test?
Many rehabilitation facilities use a version of the Functional Independence Measure (FIM). FIM as a standardized way of keeping track, or “score,” of how a patient is or is not improving. The FIM measures progress in activities of daily living, mobility, and communication.
What is a FIM assessment?
Definition: An assessment of the severity of patient disability. Context: The Functional Independence Measure (FIM™) instrument is a basic indicator of patient disability. FIM™ is used to track the changes in the functional ability of a patient during an episode of hospital rehabilitation care.
What are the 5 levels of assistance?
Levels of Assistance
- Dependent: During dependent mobility, you are unable to help at all.
- Maximal Assist:
- Moderate Assist:
- Minimal Assist:
- Contact Guard Assist:
- Stand-by Assist:
What replaced the FIM?
CMS proposes to replace the FIMTM with function data collected pursuant to the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) known as Section GG, which the agency refers to as the data items from the Quality Indicators section of the IRF PAI, as the new basis of the Case Mix Groups (CMGs)
What is a FIM Group?
FIM is an Identity and Access Management suite. It provides policy management, credential management, user management and group management. It provides self service and dynamic group management combined with Active Directory synchronization to enable accurate dynamic groups.
How long does the FIM take to administer?
The FIM was intended to be sensitive to change in an individual over the course of a comprehensive inpatient medical rehabilitation program. The FIM can be completed in approximately 20-30 minutes in conference, by observation, or by telephone interview.
Who created the FIM?
Functional Independence Measure (FIM) The FIM was developed in 1983 by a task force created by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation headed by Carl Granger and Byron Hamilton .
What is burden of care and how does it relate to the FIM?
FIM Instrument FIM scores reflect the assistance required for patients to perform both basic and instrumental activities of daily living also defined as the burden of care (22). The FIM instrument assesses 18 functions (13 motor and 5 cognitive).
Why is functional independence important?
The achievement of functional independence ensures that individuals can participate fully in life situations that are meaningful and purposeful. Whether experiencing a physical disability or not, participation in activities of daily living or life occupations is essential to health and well-being.
How do you achieve functional independence?
The concept of functional independence is a direct outgrowth of modularity and the concepts of abstraction and information hiding. Functional independence is achieved by developing modules with “single-minded” function and an “aversion” to excessive interaction with other modules.
Functional Independence Measure (FIM)
When it comes to measuring impairment, the Functional Independence Measure (FIM) is a tool that was intended to be applicable to a wide range of groups rather than being particular to any one condition. When it comes to the FIM instrument,
- There are a variety of measures of self-care independence, including sphincter control and transfers as well as mobility and communication as well as social cognition. Is a seven-level ordinal scale with 18 items and seven levels that is meant to be responsive to changes during the course of a thorough inpatient medical rehabilitation program. The amount of support required by an individual is used to grade functional status, ranging from complete independence to complete assistance)
- Patient’s level of impairment, as well as any changes in patient status in response to rehabilitation or medical intervention, are assessed using this instrument.
designed to evaluate regions of dysfunction in activities that typically occur in people with any progressive, reversible, or stable neurologic, musculoskeletal, or other condition, e.g. patients with functional mobility limitations Using the Functional Independence Measure (FIM), healthcare professionals may assess and grade a person’s functional status depending on the degree of support he or she requires.
Method of Use
Instructions for use: The FIMTM instrument is used to measure patient function at the beginning of a rehabilitation episode of treatment and at the conclusion of a rehabilitation episode of care. Within 72 hours after the commencement of a rehabilitation episode, an admission evaluation is completed by the staff member. The discharge evaluation is completed within 72 hours following the conclusion of a rehabilitation episode. The FIMTM test consists of 18 items that are divided into two subscales: motor and cognitive.
- Changing clothes for the lower body
- Bladder and bowel care, transfers (bed/chair/wheelchair)
- Transfers (toilet)
- Transfers (bath/shower)
The following items are included on the cognitive subscale:
- Comprehension, expression, social engagement, problem solving, and memory are all important skills.
Each item is graded on a 7-point ordinal scale ranging from 1 to 7, with 1 being the lowest score and 7 being the highest. The higher the score, the more independent the patient is in doing the task connected with that particular item on the checklist. Helper is not available at the FIM levels.
- 7. Complete independence (in terms of time and safety)
- 6. Independence (Device) has been modified.
Helper – Dependence that has been modified
- 5. Supervision (Subject = 100 percent)
- 4. Minimal Assistance (Subject = 75 percent or more)
- 3. Moderate Assistance (Subject = 50 percent or more)
- 5. No Assistance (Subject = 0 percent)
- 6. No Assistance (Subject = 0 percent)
Helper – Complete and total reliance
- Maximum assistance (subject = 25% or more of the total). The following options are available: 1. Total assistance or not testable (subject less than 25%)
There should be no blanks. If testing is not possible owing to danger, enter 1. The FIM received a total score of
- There will be a value between 13 and 91 for the motor subscale (the sum of all the individual motor subscale items)
- A value between 5 and 35 for the cognitive subscale (the sum of all the individual cognition subscale items)
- A value between 5 and 35 for the sensory subscale (the sum of all the individual sensory subscale items).
In the FIM instrument, the overall score (the sum of the motor and cognitive subscale scores) will range between 18 and 126 points.
Reliability and Validity
- In order to achieve satisfactory psychometric performance (intraclass correlation coefficients ranging from 0.86 to 0.88), the inter-rater reliability of FIM has been developed. A significant construct validity between items on the Barthel Index and items on the FIM, which measures functional limits, has been demonstrated by the concurrent validity with the Barthel Index (ICC0.83).
- Physical Rehabilitation-E-Book: Evidence-based examination, assessment, and intervention. Cameron MH, Monroe L. Physical Rehabilitation-E-Book: Evidence-based examination, evaluation, and intervention. Elsevier Health Sciences published a paper on April 5, 2007. 2.02.1Linacre JM, Heinemann JW, Wright BD, Granger CV, Hamilton BB. Available: (accessed on 22.5.2021)
- The functional independence measure’s structure and stability are examined in detail. Arch Phys Med Rehabil. 1994
- 75: 127-132
- Heinemann AW, Linacre JM, Wright BD, Hamilton BB, Granger C. Arch Phys Med Rehabil. 1994
- Relations between impairment and physical disability as determined by the functional independence scale. 74: 566-573
- Elia AE, Graziella F, Albanese A.12 Clinical Trials of Botulinum Toxin in Adult Spasticity. Arch Phys Med Rehabil. 1993. 74: 566-573
- Elia AE, Graziella F, Albanese A.12 Clinical Trials of Botulinum Toxin in Adult Spasticity. Botulinum Toxin E-Book: Therapeutic Clinical Practice and Science. 2009 Feb 18:148. Botulinum Toxin: Therapeutic Clinical Practice and Science. The following resources are available: (accessed 22.5.2021)
- 5.05.1AIHW FIM Available from: 22.5.20210
- Gosman-Hedstrom, G., and Svensson, E., Parallel dependability of the Functional Independence Measure and the Barthel index, published in: ADLIndex, Psychiatry 73:188, 2000
- ADLIndex, Psychiatry 73:188, 2000
What does FIM stand for in rehab?
What does the abbreviation FIM mean in rehab? It is important to note that the Functional Independence Measure (FIMTM) instrument is a fundamental indication of patient impairment. Patients’ changes in functional ability are monitored and recorded using the Functional Ability Monitoring System (FIMTM) throughout a hospitalization for rehabilitation. What exactly is rehab FIM? FIM is an abbreviation for Functional Independence Measure, which is a tool that doctors, therapists, and nurses use to assess patients during rehabilitation and physical therapy sessions.
The FIM is an ordinal scale consisting of 18 items that is utilized with all diagnoses in the rehabilitation population.
Scores lower than 6 necessitate the involvement of another person for monitoring or support.
The FIM is a technique for assessing physical and cognitive impairment, and it is designed to be used to calculate the burden of care. Self-care, sphincter control, mobility, locomotion, communication, and social cognition are among the six domains of function assessed by the 18-item test.
What does FIM stand for in rehab? – Related Questions
According to reports, the FIM takes between 30-45 minutes to administer and score, with an additional 7 minutes spent gathering demographic information at the start.
What replaced FIM?
CMS proposes to replace the FIMTM with function data collected pursuant to Section GG of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), which the agency refers to as the data items from the Quality Indicators section of the IRF PAI, as the new basis for Case Mix Groups (CMGs).
What training do you need to administer FIM?
CMS proposes to replace the FIMTM with function data collected pursuant to Section GG of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), which the agency refers to as the data items from the Quality Indicators section of the IRF PAI, as the new basis of the Case Mix Groups (CMGs).
Is FIM a self report?
Functional independence is measured using the Functional Independence Measure Self-Report (FIM-SR), which examines the burden of care and functional impairment. The patient is responsible for completing this version of the FIM.
How do you score FIM?
On a scale of one to seven, your physical therapist will rate each of the 18 items on the FIM that you complete. 2 The number seven signifies that you are entirely self-sufficient in that specific occupation. A score of one indicates that you will require complete support for the action in question.
How do I get FIM certified?
Once you have completed a workshop to get credentialed as a FIM or WeeFIM clinician, you must complete and pass a credentialing FIM or WeeFIM examination with an 80 percent or higher score in order to receive your credentialing. Following the session, you will be assigned a FIM ID number.
Is the FIM still used?
We were sorry to discover that CMS decided not to gather additional data utilizing the FIM in an IRF situation, and we expressed our disappointment to the CMS. Therefore, CMS completed the removal of the FIMTM Instrument and related Function Modifiers from the IRF-PAI for discharges commencing on or after the effective date of this final rule.
What is a FIM assessment?
Patients’ level of impairment is determined by an assessment of their severity. The Functional Independence Measure (FIMTM) tool is a fundamental indicator of patient impairment in a variety of settings. Patients’ changes in functional ability are monitored and recorded using the Functional Ability Monitoring System (FIMTM) throughout a hospitalization for rehabilitation.
Is FIM standardized?
FIM is a standardized method of keeping track, or keeping a “score,” of how well or poorly a patient is or is not progressing. The FIM assesses improvement in daily living tasks, mobility, and communication, among other things. The FIM is divided into five basic categories, each of which has 18 separate work areas, and it takes less than an hour to complete.
What is considered modified independence?
Independence with a twist (FIM 6) If any of the following are true, it is likely that an assistive technology is necessary; the activity takes longer than acceptable time; or there are safety (risk) issues; and no manual aid or helper is required.
What is level of independence?
A person’s level of functional independence, as indicated by a FIMTM score-based code, is defined as Functional independence is defined as the capacity to do activities of daily living in a safe and self-sufficient manner.
Person—level of functional independence is the concept behind the data element.
What is the 60 rule requirement?
Known as the 60 percent Rule, this Medicare facility criteria mandates each inpatient rehabilitation facility (IRF) to discharge at least 60 percent of its patients who have one of thirteen qualifying diseases.
What is a PPS coordinator?
The PPS coordinator is responsible for the entire coordination of activities that support the Prospective Payment System (PPS) process for the inpatient rehabilitation unit, including the design, development, and implementation of new initiatives.
What is an IRF Pai?
The IRF-PAI is the patient assessment instrument that IRF providers use to collect patient assessment data for the purpose of calculating quality measures and determining payment in compliance with the IRF Quality Reporting Program (IRF QRP) (QRP).
What is meant by functional independence?
INTRODUCTION. The capacity to carry out activities of daily living may be described as an individual’s ability to function independently (ADLs). The capacity to live independently in a domiciliary setting is ensured by a person’s ability to execute duties alone.
What is the functional independence measure for children?
The WeeFIM (WeeFIM for Children) is a simple-to-administer scale that assesses independence across three areas in American children under the age of five. WeeFIM is an 18-item, 7-level ordinal scale instrument that assesses a child’s consistent performance in key daily functioning abilities. It was developed by the National Institute of Mental Health.
Who created FIM?
Carl Granger and Byron Hamilton were the leaders of a task committee established by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation in 1983 to design the Functional Independence Measure.
What is FIM instrument?
The FIM instrument serves as a fundamental indication of the severity of a person’s impairment. It is necessary to follow a patient’s functional ability changes as they occur throughout rehabilitation, and the FIM instrument is utilized to do so. The ability to do daily activities is a critical outcome metric of rehabilitation sessions.
What does functional mobility mean?
Historical context: Functional mobility (FM) is the capacity of a person to move in order to complete daily living duties and activities.
What does stand by assistance mean?
Standby Assistance is defined as the presence of another person within arm’s reach who is necessary to prevent injury while performing one of the activities of daily life in order to prevent injury. An example of standby help would be if a person need someone to be present to catch them if they fall while getting into and out of the bath.
What is ECE helmet rating?
ECE is an abbreviation for the Economic Commission for Europe. It is a multi-national standard rating that is used by more than fifty (50) nations in Europe and is based on a set of criteria. A helmet that has an ECE 22.05 label on it is completely safe to use in any situation. It is a helmet that has the potential to save your life in life-threatening situations.
The Role of the FIM in Physical Therapy
On September 10, 2021, an update was made. An outcome measuring instrument used by physical therapists and other healthcare practitioners to assess overall independence while doing particular functional tasks is the Functional Independence Measurement (FIM).
Patient’s with functional mobility impairments are most typically seen in acute care hospitals and subacute rehabilitation settings, although it may be utilized anyplace for patients with functional mobility impairments. Photograph by Blend Images / Getty Images.
Parts of the FIM
In all, the FIM consists of 18 particular activities that are routinely examined and treated by physical and occupational therapy experts as well as nurses and other rehabilitation specialists in the United States. Mobility, walking, self-care, and communication are examples of tasks that fall within this category. The FIM is organized into six primary areas, with a variety of tasks in each category being evaluated. These sections are devoted to numerous functional mobility activities that you may encounter during the course of a typical day at the office.
- Food preparation
- Upper body dressing
- Lower body dressing
- Bathroom use
- Transplantation from bed to wheelchair
- Transfusion from toilet to wheelchair Transfer: mobility in the tub and shower
On a scale of one to seven, your physical therapist will rate each of the 18 items on the FIM that you complete. The number seven signifies that you are entirely self-sufficient in that specific occupation. A score of one indicates that you will require complete support for the action in question. So the FIM requires at least an 18 on the scale, with the maximum score being 126, which shows total independence. The following is a comprehensive list of the FIM’s final results:
- The whole amount of assistance is required. Maximal assistance (you can complete 25 percent of the job)
- Moderate assistance (you can complete 50 percent of the task)
- Minimal assistance (you can complete 75 percent of the assignment)
- And no assistance. It is necessary to have supervision. Modified independence (you make use of an assistance device)
- Independence in carrying out the work
Needed for complete assistance Help at the highest level (you can complete 25 percent of the job); moderately assist (you can complete 50 percent of the task); minimally assist (you can complete 75 percent of the assignment). It is necessary to have supervision; Independence with a modification (you utilize an assistive device); independence in accomplishing the task
A Word From Verywell
Your healthcare team will most likely use an outcome measuring instrument to document your progress and determine your functional mobility and self-care independence if you are ever admitted to a hospital. When your physical therapist and other specialists evaluate your progress during your episode of care, the FIM may be one of the tools they use to determine your progress. This outcome assessment can also serve as a morale booster, since as your FIM score increases, you will be able to see that your general mobility and functional abilities are improving as well.
Thank you for sharing your thoughts!
There was a clerical error.
CARE Item Set / Section GG for ARU Inpatient Rehab (vs FIM) Revisited – OT Dude
It is abbreviated as CARE, which stands for Continuity Assessment Record and Evaluation. To begin, let us discuss the CARE instrument, which may be regarded of as a functional independence measure substitute in acute rehab or inpatient rehab for occupational therapy in acute rehab or inpatient rehab. For occupational therapists who practice in this context, this post will provide an overview of how the CARE tool differs from the FIM tool in terms of functionality. My name is Jeff, and I work in inpatient rehabilitation.
- My experience with FIM and the CARE tool dates back to when it was originally adopted and enforced by CMS in the ARU region.
- It may be thought of as a substitute for the FIM system.
- What is it about the CARE tool that we are so concerned about?
- In the United States, Medicare is regarded as the “gold standard” in health-care provision.
- Although the FIM was superseded by the CMS, or the Center for Medicare and Medicaid Services, this does not imply that the FIM is no longer in use.
- You will very certainly study about the FIM while in OT school.
- One thing to keep in mind is that the numbers for the CARE tool scores have a 0 prefix before them for the single digits, so 01, 02, 03, etc.
— and that the numbers for the CARE tool scores are not 1, 2, 3, etc.
The CARE tool deleted the number 7, which was adjusted in a separate manner.
To summarize, even when the score may not indicate that a patient is impaired in the performance of a specific task, such as an ADL, the occupational therapist can always mention this in the narrative component to be more precise.
The CARE tool has made this a lot more difficult to understand.
According to the CARE tool, a customer is never “expected to be” exactly 50 percent of the time.
You may think of it as rounding down from 50% to 49% of a percentage.
There is no longer a “min assist,” and the term “partial assist” has been used.
Please allow me to reiterate.
This implies that a customer can theoretically start off as min assist and proceed to moderate help in the traditional sense, but the CARE tool will still give them the same score, which is 03.
Allow me to repeat myself on that one.
In other words, it is now more difficult for a client to demonstrate functional changes in the eyes of the CARE tool scores due to the fact that, aside from being dependent and under supervision, they can only have two possible CARE tool scores: 02 for substantial/max assist and 03 for partial/moderate assist.
- In addition, there have been several updates to the CARE tool.
- In addition, owing to environmental restrictions and medical conditions, other scenarios are not attempted or are not suitable for the situation.
- So if the OT assists with 70 percent of the body parts for a shower, it would be substantial/maximal assistance, which would be a number of two.
- And don’t worry, in order to score the CARE instrument in occupational therapy practice, you must first be taught and certified.
Check out my blog article and decision tree calculator for more information on the CARE tool, which generates a CARE tool score based on the amount of independence or restrictions of the patient.
FIM-score predictors of discharge destination in older patients admitted for inpatient rehabilitation
PREFACE When admitted to a hospital for an acute illness, elderly patients who are at higher risk of multimorbidity may lose essential skills to perform activities of daily living (ADL) and thus their independence. This can occur not only as a result of the acute illness that led to the admission, but also as a result of a lack of individual therapeutic management. 3 The findings of Covinskyet al indicated that up to 50% of patients over the age of 85 had a weaker function in the activities of daily living after being admitted to the hospital than they had before the acute illness.
Patients who are admitted to the hospital should be made aware of the possibility of further loss of independence that may occur during their hospitalization.
These people frequently require rehabilitation following an acute illness, accident, or surgery in order to restore their functional independence.
In order to confirm the clinical finding that some specific FIM elements appear to be particularly helpful in predicting discharge to home, the following steps were taken: MethodsOur rehabilitation center is part of the public hospital (HFR) in the Swiss canton of Fribourg (population 318,000), which is a component of the HFR.
- Exclusion criteria included death during admission, discharge to any acute hospital (somatic, psychiatric, or geriatric), or any other rehabilitation institution, as well as an unknown discharge location (for example, a nursing home).
- The following information was gathered: age, gender, marital status, length of stay, discharge location, and FIM scores on admission and discharge.
- The data from the trial was anonymised by the lead investigator before it was provided to a statistical analyst for evaluation.
- Medical conditions and medicines were examined, and all participants got physiotherapy and occupational treatment that was tailored to their specific functional and cognitive limitations as well as their personal objectives.
- Our social workers assist with discharge planning and the coordination of any further assistive devices that may be required.
- Treatment objectives are established, and discharge planning is initiated with patient participation.
- A total of 18 to 126 points are awarded for each item, with scores ranging from 1 (full reliance) to 7 (perfect independence) for each item.
A patient living alone, demands better physical and cognitive abilities than a person living with a spouse or other caretaker.
For a person who does not live alone, a score of 3 or above for the aforementioned tasks (indicating the need for some physical assistance) may be adequate for home release.
It is also possible for that individual to assist with other tasks of daily living that are not absolutely necessary.
Furthermore, at least one meeting with the patient’s family and other individuals who would be engaged in his or her care following rehabilitation was scheduled to discuss discharge plans with the patient.
The FIM score was re-evaluated 72 hours before release, and all necessary external assistance was arranged at that time.
In Lausanne, on the 13th of October 2014, the Swiss ethics commission approved approval for the project.
To determine whether a patient would be released home or to a mental health facility, the researchers used logistic regression to examine the relationship between each FIM sub-score, as well as age, gender, and marital status.
Decades were used to indicate the passage of time.
Multivariate studies included all factors, including interest, age, gender, and marital status, whereas univariate analyses included just a single variable, such as marital status.
The odds ratios presented for all FIM scores are based on a one standard deviation change in the FIM score.
Following the application of exclusion criteria, 2218 participants were accepted into the research.
Out of this total, 1386 (80.3 percent) were able to return home, while 341 (19.7 percent) were sent to a nursing home or comparable facility.
Patients who were discharged to their homes had an average age of 77.8 9.9 years (standard deviation), whereas those who were sent to an institution had an average age of 83.4 7.86 years (standard deviation).
63 percent vs.
In the research, more than 80% of the participants were released home after an average length of stay (LOS) in rehabilitation of 22 days (interquartile range = 14 – 27 days).
The demographic information, baseline characteristics, and discharge characteristics are shown in Table 1.
Table 1 shows the demographics, baseline characteristics, and discharge characteristics of the study participants.
The results of t-tests or Wilcoxon rank sum tests are referred to as P values (subscores and time in rehabilitation).
During their stay, they also saw a lower rise in total and motor FIM scores, but there was no statistically significant difference in the change in cognitive scores or its sub-scores (table 2).
As shown in Table 3, the results of univariate and multivariate analyses of risk variables evaluated at the time of admission (age, marital status, gender, and FIM Scores) as well as multivariate analyses (FIM sub-scores) are presented.
The findings revealed that autonomy in eating and drinking, personal cleanliness, and the ability to transfer independently are all important motor abilities for release home after a hospitalization.
Table 3 shows the effects of baseline parameters on the location of discharge.
UA stands for univariate analysis, and MA stands for multivariate analysis.
The most significant cognitive function sub-scores for discharge home were acoustic/visual understanding and social behavior, which were closely followed by expressiveness (verbal/nonverbal) and memory.
Table 4 demonstrates that, among patients living alone, divorced patients had substantially better overall FIM scores and greater functional ability than either singles or widowed patients (as measured by the FIM).
DISCUSSION C It was in 1983 that V Granger and his colleagues, working as part of a joint task force appointed jointly by the American Academy of Physical Medicine and Rehabilitation and the American Congress of Rehabilitation Medicine, developed a uniform data set for measuring disability and rehabilitation outcomes.
This standard was developed by the University at Buffalo South, which was awarded a three-year funding by the National Institute for Disability and Rehabilitation Research in 1984 to produce a national standard.
4 Faculty members in the University at Buffalo Department of Rehabilitation Medicine were involved with the federal Health Care Financing Administration (HCFA) in developing an instrument to be used by rehabilitation hospitals and other rehabilitation units as the basis for Medicare prospective payment in 1998, fifteen years after the FIM instrument was developed.
In addition, it has evolved into a method of calculating insurance companies’ payments to inpatient rehabilitation centers.
5-7 The majority of them are based on a specific subset of patients — for example, those who have had a stroke 5,6or hip fractures.
According to Reistetteret al, a total FIM score of 78 indicates that a patient is likely to return home,6 whereas the review by Bottemilleret alcited several articles suggesting that a FIM score on discharge80 indicated that a patient was likely to return home, compared to scores40, which indicated a patient was only 30% likely to return home.
- The majority of investigations have been carried out on specific patient groups (8-13).
- 14Other studies have included varied patient groups 15-17; however, to our knowledge, this is the first research to examine the efficacy of the FIM Instrument in the discharge planning of a large range of patients in an unselected patient population.
- Although the majority of studies revealed that motor 13,16,17, and cognitive 13,17skills were significant predictors, Astellet and colleagues discovered that independence in ADL was the most important predictor.
- 17 Others, such as Shashiet al, were able to discover variables that were comparable to ours, such as age, gender, cognitive and motor skills, 13but others concluded that age was a weak predictor.
- Only the item for intimate hygiene changed considerably in the selected motor sub-scores during rehabilitation, confirming our clinical finding that this appears to be a critical component for returning home.
- According to our interpretation, age has a smaller impact on patient functionality than multimorbidity on a single day.
- 13,17 Other findings included the fact that patients who were released to an institution had a lengthier duration of stay, which was not surprising and had been discovered by other researchers.
- If a patient’s general disposition is poor and discharge to home is consequently in doubt, we plan for both outcomes very early on in the rehabilitation process and coordinate applications for admission to a nursing home with the patient and his or her family as early as possible.
- Previous research 6discovered that a cut-off value of 78 (total FIM score) accurately indicated the site of discharge.
- Based on our data, this number has strong sensitivity (74.4 percent), but poor specificity (only 57.8 percent) (37.0 percent ).
- So patients with a total FIM score78 were either discharged home or admitted to an institution with a score78 accounted for around 20% of those who were released.
Extensive discharge planning based on the International Classification of Functioning, Disability, and Health goal settings is what we have found to be the most effective method of determining the patient’s final destination, taking into account the patient’s personal resources, contextual factors, and individual FIM scores, particularly the sub-scores for intimate hygiene, bladder and bowel management.
- The fact that divorced patients had the highest FIM may indicate that these patients have a strong desire to be on their own in their lives.
- This information is not gathered in our hospital administrative database.
- CONCLUSIONIn this study, the age of the participants was shown to be positively connected to their release from the institution.
- In general, total FIM scores distinguished the best between patients who were discharged to a nursing home and those who were discharged to their own homes, but that score alone was not able to predict accurately where patients would be discharged.
- Nonetheless, greater research into the actual use of the FIM score is required.
- Ethics: The Swiss Ethics Committee in Lausanne has given its approval for this project.
Professor Dr. Wolfram Weinrebe is the corresponding author. He is a professor in the Department of General Internal Medicine and Geriatric Medicine at the Campus Spital Hirslanden in Bern, Switzerland, at Schänzlistrasse 39 in 3032 Bern. Email:[email protected]
What does the FIM stand for?
The Functional Independence Measure (FIM TM) instrument is a fundamental indicator of patient impairment. The Functional Independence Measure (FIM TM) instrument is used to track the changes in a patient’s functional abilities during an episode of inpatient rehabilitation therapy.
|FIM||Face in the Mirror|
|FIM||Finance and Information Management|
|FIM||Federation Internationale de Motocyclisme|
|FIM||Functional Independence Measure (scale for measuring level of assistance in rehabilitation)|
Furthermore, what exactly is an FMI phone call? FMI is an abbreviation for “For Further Information.” So now that you know what FMI stands for (which is “For More Information”), please do not thank us. YW! What exactly is FMI stand for? In the section above where theFMIdefinition is provided, you will find an explanation of what FMIis, what it stands for, and what it means. It was also inquired as to what the entire form of FIM was. Forefront Identity Manager (FIM) is a collection of apps that, when combined, create a comprehensive Identity and Access Management system for managing identities, credentials, and role-based access control rules in a corporate environment.
It is a document supplied by an airline as a substitute ticket voucher in the event that the passenger’s original travel plans are interrupted due to a schedule change, overbooking, or cancellation of the flight.
|Wright, J. (2000). The FIM(TM).The Center for Outcome Measurement in Brain Injury. (accessed).* *Note:This citation is for the COMBI web material. Mr. Wright is not the scale author for the FIM.|
|The FIM(TM)* (Guide for the Uniform Data Set for Medical Rehabilitation, 1996) is the most widely accepted functional assessment measure in use in the rehabilitation community. The FIM(TM) is an 18-item ordinal scale, used with all diagnoses within a rehabilitation population. It is viewed as most useful for assessment of progress during inpatient rehabilitation. The FIM(TM) has become proprietary, and therefore the scale, syllabus, and training materials are not provided in the COMBI. For further information on the FIM(TM), please contact: Uniform Data System for Medical Rehabilitation270 Northpointe Parkway, Suite 300Amherst, New York 14228(716) 817-7800 FAX (716) 568-0037email:[email protected] site: FIM(TM) is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc. *For over 15 years, FIM was an acronym for “Functional Independence Measure”. It is still often cited as this in the literature. The current owners of the FIM(TM) instrument have decided that the acronym FIM(TM) no longer stands for anything and should be referred to only as FIM(TM). Information regarding the FIM(TM) was contributed bySanta Clara Valley Medical Center. Please contact Mr. Jerry Wright atfor questions regarding the presented information. If you find the information in the COMBI useful, please mention it when citing sources of information. The information on the FIM(TM) may be cited as:Wright, J. (2000). The FIM(TM).The Center for Outcome Measurement in Brain Injury. (accessed).|
Functional Independence Measure
|Metadata item type:||Glossary Item|
|Registration status:||Health, Standard 11/04/2014 Tasmanian Health, Endorsed 20/12/2016 Independent Hospital Pricing Authority, Standard 31/10/2012|
|Definition:||An assessment of the severity of patient disability.|
|Context:||The Functional Independence Measure (FIM™) instrument is a basic indicator of patient disability. FIM™ is used to track the changes in the functional ability of a patient during an episode of hospital rehabilitation care.|
Collection and usage attributes
|Guide for use:||Patient function is assessed using the FIM™ instrument at the start of a rehabilitation episode of care and at the end of a rehabilitation episode of care. Admission assessment is collected within 72 hours of the start of a rehabilitation episode. Discharge assessment is collected within 72 hours prior to the end of a rehabilitation episode.|
|Comments:||FIM™ is comprised of 18 items, grouped into 2 subscales – motor and cognition.The motor subscale includes:|
- Aside from that, what exactly is an FMI call? To request further information, use the abbreviation FMI. Don’t thank us now that you know -FMI is an abbreviation for “For More Information.” YW! Was FMI a slang phrase? In the section above where theFMIdefinition is provided, you will find an explanation of what FMIis and what it stands for. FIM’s entire name has also been inquired about. Identity and access management system Forefront Identity Manager (FIM) is a collection of programs that work together to provide a full Identity and Access Management system for managing identities, credentials, and roles-based access control rules. The FIM aviation organization defines itself as follows: It is a document supplied by an airline as a substitute ticket voucher in the event that the passenger’s original travel plans are disrupted due to a schedule change, overbooking, cancellation, or other unforeseen circumstances.
The following items are included on the cognitive subscale:
- Comprehension, expression, social engagement, problem solving, and memory are all important skills.
Source and reference attributes
|Submitting organisation:||Independent Hospital Pricing Authority|
|Origin:||FIM™ is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities Incorporated.Australasian Rehabilitation Outcomes Centre holds the territory license for the use of the FIM™ instrument in Australia.|
|Reference documents:||Uniform Data System for Medical Rehabilitation 2009. The FIM System® Clinical Guide, Version 5.2. Buffalo: UDSMR.Australasian Rehabilitation Outcomes Centre, University of Wollongong 2012. What is the FIM™ Instrument? Viewed 19 September 2012, colspan=”2″>|
|Metadata items which use this glossary item:||Activity based funding: Admitted sub-acute and non-acute hospital care DSS 2013-2014Independent Hospital Pricing Authority, Standard 11/10/2012Admitted subacute and non-acute hospital care DSS 2014-15Health, Superseded 13/11/2014Admitted subacute and non-acute hospital care DSS 2015-16Health, Superseded 19/11/2015Admitted subacute and non-acute hospital care NBEDS 2016-17Health, Superseded 03/11/2016Admitted subacute and non-acute hospital care NBEDS 2017-18Health, Superseded 25/01/2018 Independent Hospital Pricing Authority, Recorded 04/08/2016Admitted subacute and non-acute hospital care NBEDS 2018-19Health, Superseded 17/10/2018Admitted subacute and non-acute hospital care NBEDS 2019-20Health, Superseded 18/12/2019Admitted subacute and non-acute hospital care NBEDS 2020–21Health, Superseded 05/02/2021Admitted subacute and non-acute hospital care NBEDS 2021–22Health, Superseded 20/10/2021Admitted subacute and non-acute hospital care NBEDS 2022–23Health, Standard 20/10/2021Episode of admitted patient care—clinical assessment score, code NNIndependent Hospital Pricing Authority, Standard 30/10/2012Functional Independence Measure score code NHealth, Standard 18/12/2019 Tasmanian Health, Endorsed 06/05/2020Person—level of functional independence, Functional Independence Measure score code NHealth, Standard 18/12/2019 Tasmanian Health, Endorsed 06/05/2020|
King’s College London – FIM+FAM
In addition to the Functional Independence Measure (FIM), which is a global measure of impairment, the Functional Assessment Measure (FAM) has an additional 12 questions that together comprise the Functional Assessment Measure (FAM). FAM does not exist in a vacuum, which is why the acronym FIM+FAM is used. As a result, a user group in the United Kingdom changed the FAM items to create a UK version (UK FIM+FAM). The original items were produced by Santa Clara Valley Medical Center (SCVMC), however extrapolation to the United Kingdom was not achievable.
- The current version of FIM+FAM in use in the United Kingdom is Version 2.2, which combines FIM Version 4.
- It uses an ordinal scoring method for all 30 categories, with numbers ranging from 1 to 7 (1 representing complete reliance and 7 representing complete independence).
- A target score can be established at the same time as the admission score is recorded, and it is based on the therapeutic action that is intended.
- Units aspiring to Level 1 or Level 2 services under the UK ROC project are required to meet the FIM + FAM outcome measure.
A UK FIM+FAM training day is necessary for all ROC units in the United Kingdom. Please email Elica Ming-Brown if you would like further information on forthcoming course details. Alternatively, you may obtain the pre-course self-service training slides from the following link:
- Slides for self-service training – Part 1 (PDF)
- Self-service training slides – Part 2 (PDF)
- Self-service training slides – Part 3 (PDF)
- EADL training slides (PDF)
- Self-service training slides – Part 4 (PDF)
The following documents, including the scoring manual and a sample score sheet, are available for download:
FIM FAM Publications
- The UK Functional Assessment Measure (UK FIM+FAM): Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation Following a Stroke from the National UK Clinical Dataset,PLoS One, Nayar M, Vanderstay R, Siegert RJ, Turner-Stokes L. The UK Functional Assessment Measure (UK FIM+FAM): Psychometric Evaluation in Patients Undergoing Specialist Rehabilitation Following a Stroke from the National UK Clinical Dataset,PLoS One. 2016 Jan 29
- Published online January 29, 2016. The FIM + FAM in the United Kingdom: a complete psychometric study, Disabil Rehabil., Turner-Stokes L, Siegert RJ. 2013
- Is the UK FIM+FAM Extended Activities of Daily Living module reliable and accurate? Janet Law ab
- Beverley Fielding ab
- Diana Jackson ab
- Lynne Turner-Stokes J, Fielding B, Jackson D, Turner-Stokes L.The UK FIM+FAM Extended Activities of Daily Living module: evaluation of scoring accuracy and reliability (PDF,271kb), Informa Healthcare2008 Nov 1
- Turner-Stokes, L., Nyein, K., Turner-Stokes, T., and Gatehouse, C. The creation and evaluation of the UK FIM+FAM Clin Rehabil., Functional Assessment Measure (PDF, 374kb), Clinical Rehabilitation. 14(4):278–87, published online 1999 August.
FIM / WeeFIM – University of Wollongong – UOW
- • The FIM instrument in Australia
- • Developing a Measure of Function
- • The FIM instrument in the United Kingdom
The FIM instrument serves as a fundamental indication of the severity of a person’s impairment. It is necessary to follow a patient’s functional ability changes as they occur throughout rehabilitation, and the FIM instrument is utilized to do so. The ability to do daily activities is a critical outcome metric of rehabilitation sessions. The FIM instrument consists of 18 items, each of which is scored on a seven-point ordinal scale, with the higher the score for an item indicating that the patient is more independently able to do the tasks examined by that item.
A total of 13 motor items and 5 cognitive items make up the first two major groups of items.
The rating scale denotes significant shifts in behavior, such as the transition from reliance to independence.
If assistance is required, the scale determines the extent to which assistance is required.
For this reason, the National Institute on Disability and Rehabilitation Research of the US Department of Education awarded a grant to the Department of Rehabilitation Medicine of the School of Medicine and Biomedical Sciences at the State University of New York at Buffalo to develop a system to document the severity of patient disability and the outcomes of medical rehab.
It is now extensively used all around the world, including in Australia, and has become increasingly popular.
All physicians who conduct assessments get training in the tools’ usage, and they must pass a credentialing exam every two years to maintain their licenses.
Clinicians are the lowest level of credentialing.
Admission data is gathered as soon as feasible after admission in order to create an adequate baseline, and discharge data is taken right before the patient is released from the hospital.
The grade should be based on the actual performance that was witnessed.
It is critical to complete the initial measurement in a timely way in order to obtain an accurate base measure.
The AROC data set needs the collection of the date on which each of these scores was reached in order to be able to measure the timeliness of scoring during both admission and discharge.
* Uniform Data System for Medical Rehabilitation, a branch of UB Foundation Activities, Inc., owns the trademarks FIMTM and WeeFIM®, which are used with permission.