The Value of the Basic Mobility “6-clicks” AM-PAC to Prevent Duplication of Services Within the Inpatient Multidisciplinary Cardiopulmonary Team
Introduction: Lehigh Valley Health Network is a large hospital system in Eastern Pennsylvania. This hospital system consists of the main location in Allentown and 6 satellite locations. Over the last decade, it has demonstrated some of the highest cardiac surgery volumes in Pennsylvania. This volume is primarily located at the Allentown location and the satellite campus, Muhlenberg, in Bethlehem, PA. For patients status post Coronary Artery Bypass Grafting (CABG), acute care Physical Therapy and Cardiac Rehabilitation are highly utilized to facilitate mobility and prevent functional decline.
Purpose: With the high utilization of physical therapy and cardiac rehab in patient who are status post CABG, it is increasingly important to maximize patient access and eliminate waste. The aim of this study was to determine the efficacy of the AM-PAC “6-clicks” Basic Mobility functional assessment to prevent duplication of services between inpatient physical therapy and cardiac rehab.
Design: The AM-PAC short form contains 6 questions to determine level of assistance needed for basic functional mobility tasks. Prior to data collection, all staff members of the Cardiopulmonary service line completed an AM-PAC competency. Cardiac rehab was identified as the primary service on patients scoring 19 or above. Physical therapy was identified as being primary service on patients scoring under a 19. Cardiac rehab remained on caseload as a secondary service in those patients scoring under a 19. Exclusion Criteria: redo CABG, combined cardiac surgery procedures, transfer back to ICU, underlying gait dysfunction, reintubation, acute CVA following surgery.
Methods: Data was collected from September 2017 to March 2018. Between the two primary sites, 173 patients were identified as meeting inclusion criteria. The AM-PAC was completed status post CABG on the day of transfer from ICU to the step down unit or following extubation when ambulation was initiated. The initial AM-PAC score was communicated at multidisciplinary rounds to assure patient's needs were being met using most appropriate service.
Results: Out of the 173 patients, Cardiac Rehab was consulted on all patients while Physical Therapy was consulted on 85 patients. Out of these 85 patients, 30 were seen for an initial evaluation and then triaged from Physical Therapy caseload. Data collection showed utilizing the AM-PAC in this manner prevented duplication of services for 35% of patients who had Physical Therapy consults placed.
Conclusions: AM-PAC is a quick and effective tool to prevent duplication of services in the acute care setting status post CABG. Further research needs to be conducted to examine whether 19 is the most appropriate cut-off score. More investigation could also occur to explore an appropriate score to triage to a non-skilled restorative walking program.
AACVPR 33rd Annual Meeting Scientific Abstract Presentations
Published In/Presented At
Blaha, C. Blessing, K. Vetter, R. (2018). The Value of the Basic Mobility “6-clicks” AM-PAC to Prevent Duplication of Services Within the Inpatient Multidisciplinary Cardiopulmonary Team. Journal of Cardiovascular Rehabilitation & Clinical Cardiology. 38(5)- E19-E20.
Medicine and Health Sciences | Occupational Therapy | Rehabilitation and Therapy
Department of Medicine