Subacute Care Home <

Outcome Measures in Rehabilitation

In October 2001 the National Ageing Research Institute (NARI) completed Phase 1 of the “Outcome Measures in Rehabilitation’ project. This was in response to widespread concern in the field that the broad spectrum of interventions involved in rehabilitation were assessed on disability measures alone. The project identified a measurement framework that reflected the impact of the rehabilitation team’s collective efforts.

After extensive analysis of the research literature and consultations with the field across Victoria, two measures were selected as trialing in the inpatient rehabilitation setting. The two instruments were the Handicap Assessment Resource Tool (HART) and the Functional Autonomy Measuring System (Systeme de Mesure de l’Autonomie Fonctionnelle – SMAF). These measures assess “Personal Care Handicap”, that is the patient’s ability to carry out activities of daily living.

Rehabilitation teams are concerned with both reducing disability and with helping patients manage residual handicap. Phase 2 of this 2002 project field-tested the SMAF and the HART for their comparative clinical and administrative utility. There were 14 rehabilitation teams in the study from metropolitan and rural centres. HART was judged to be the better tool and is being recommended for use in the Victorian public inpatient rehabilitation settings. The full Phase 1 and Phase 2 reports by NARI can be accessed below.

In June 2003, as part of the Acute to Sub-acute Breakthrough Collaborative, Health Services were invited to express an interest in introducing the Handicap Assessment and Resource Tool (HART) into their sub-acute inpatient setting. From this process the following five Health Services were selected to participate - Barwon Health, Peninsula Health, Southern Health, Northern Health and St.Vincent’s Health.

The Monash Ageing Research Centre (MONARC) was contracted by the Department of Human Services to implement and evaluate the introduction of the HART within the five Health Services. The project commenced in August 2003 with workshops for clinical staff and managers held at each Health Service.

A more intensive education program was provided for the clinician nominated as the site champion for each Health Service. The site champion has taken a lead role in the implementation of the HART and has a nominated support person who they can contact for advice and assistance. Regular meetings have been held with the site champions in conjunction with representatives from the MONARC and the Department to discuss and support the implementation of the HART.

The project is due for completion in April 2004. An overall and site specific evaluation is currently underway.

^ Top