AM-PAC Scores and Therapy Orders: Supporting Appropriate Utilization of Skilled Therapy

By Erin Chung, DO, hospitalist, Miami Valley Hospital, and associate program medical director; Benjamin Fornshell, BSN, RN, patient safety coordinator; Lisa Holscher, PT, acute therapy program manager; and Roopsi Narayan, MPH, CPH, director of hospital operations, Miami Valley Hospital.

Premier Health has been on a journey to improve patient mobility across the organization. Consistent use of the Activity Measure for Post-Acute Care (AM-PAC) score helps care teams assess a patient's functional mobility and establish daily mobility goals, such as getting out of bed to a chair, walking in the hallway or increasing overall activity levels.

The AM-PAC score also helps determine whether a patient requires skilled physical or occupational therapy services or can be safely mobilized by nursing staff. AM-PAC mobility scores range from 6 to 24, with higher scores indicating greater independence. Patients with scores of 23 or 24 generally function at a level that allows them to safely mobilize without the need for skilled therapy intervention. In many cases, nursing staff can support these patients through routine care and established mobility goals.

Appropriately identifying patients who require skilled therapy services allow therapists to focus their expertise on those with more complex rehabilitation needs while continuing to promote mobility for all patients.

What Is Changing?

Beginning soon, providers who place a physical therapy or occupational therapy order for a patient with a documented AM-PAC score of 23 or 24 will see a clinical decision support alert. The alert will prompt providers to consider whether skilled therapy services are needed based on the patient's current level of function.

There may be circumstances in which therapy remains clinically appropriate, and providers may proceed with the order when indicated. The purpose of the alert is not to prevent therapy referrals, but to encourage thoughtful utilization of rehabilitation services and support efficient, patient-centered care.

Thank you for your partnership in ensuring rehabilitation resources are directed to the patients who will benefit most from skilled therapy intervention.

Questions? Contact Erin Chung, DO, at eachung@premierhealth.com.

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