The quality of care given to patients receiving medical rehabilitation while in the hospital is measured with a tool called the Functional Independence Measure (FIM). Using this tool, rehabilitation specialists working with patients can measure their progress from admission through discharge. Often the type of patients admitted to the rehabilitation unit has sustained a catastrophic event or debilitating surgery or illness.

The FIM looks at 18 discrete functions of daily life to rate the patient's severity of disability and level of independence. Each functional item is rated on a seven-point scale. Scores can range from 18 (totally dependent) to 126 (totally independent). Areas rated include the patient's ability to care for him or herself, sphincter control, mobility, communication and social cognition. An interdisciplinary team at admission and again at discharge performs assessments to measure attainment of a patient's specific goals.

Medical rehabilitation facilities throughout the United States submit the data they collect using FIM to the Uniform Data System for Medical Rehabilitation in Buffalo, NY. National benchmarks for rehabilitation care are created using this data. In 2006, 893 organizations participated in the system, providing 427,755 patient records. The data in the charts below reflects patients discharged between Jan. 1 and Dec. 31, 2006.

Cedars-Sinai Inpatient Rehabilitation unit is accredited by the Commission on Accreditation for Rehabilitation Facilities (CARF) as well as having CARF subspecialty certification for stroke.

The first chart below compares the types of patients treated at Cedars-Sinai Medical Center with the types of patients treated at facilities nationally.

The following chart reflects the types of injuries or conditions that bring patients at Cedars-Sinai Medical Center to medical rehabilitation while they are in the hospital.

Generally, the less time that a patient is required to stay in a hospital the better. Being able to leave a hospital sooner is an indicator of recovering better and faster.

The table below compares the average length of stay experienced by inpatient rehabilitation patients at Cedars-Sinai compared to patients at medical rehabilitation facilities around the nation.

The goal of medical rehabilitation is to improve the patient's independence in functional activities so that he or she can be as self-sufficient as possible. Signs that this goal has been reached include:

• Being able to be discharged from the hospital
• Improvements in the patients Functional Improvement Measure score
• Still being able to live in the community 80 to 180 days after discharge from inpatient rehabilitation
• The patient's perception of quality of life
• Percentage of patients living 80 to 180 days after discharge
  

The table below shows the percentage of patients at Cedars-Sinai who were discharged to their own homes or to board and care, retirement or assisted living facilities. This is compared with discharge rates on average nationally.

The chart below compares functional improvement scores measured at admission, discharge and 80 to 180 days after discharge for patients treated at Cedars-Sinai. This information is compared to national averages.

At Cedars-Sinai, patients on average were admitted with a functional improvement score of 67.8. This indicates that patients needed a moderate level of assistance. Overall at discharge, Cedars-Sinai patients on average had a functional score of 87.4. This shows that patients needed minimal assistance when they were discharged. At the time of follow-up 80 to 180 days after discharge, Cedars-Sinai patients had an average functional improvement score of 107.7. This indicated that the patients were independent with either an assistive device (such as a cane or walker) or additional time to complete activities.

More than 97% of Cedars-Sinai inpatient medical rehabilitation patients were still living in the community 80 to 180 days after discharge. By comparison, nationally less than 95% of patients who had received inpatient medical rehabilitation were living in the community 80 to 180 days after discharge.

Following discharge from the medical center, patients were asked to respond using a five-point scale to the statement, "The rehabilitation program improved the quality of my life." The scale ranged from "strongly agree" (5) to "not applicable" (1). On the scale, 2 signified "strongly disagree," 3 signified "some disagreement" and 4 "some agreement."

Patients who had received inpatient medical rehabilitation at Cedars-Sinai rated their quality of life at 3.2 on the scale. On average nationally, patients rated their perceived quality of life at 3.3.

Nearly 96% of Cedars-Sinai inpatient medical rehabilitation patients were still living 80 to 180 days after discharge, compared to 95% of patients nationally.