Ron, thats intersting-previously we have been told that goals such as "increase shouder range of motion by 30 degreees" or "increase UE muscle strength to grade 4+" etc are no good because they still don't communicate improvement in function. So by extension, outcomes that are based only on improvements in ROM, strength etc would also not be truly indicative of improved function. It seems to me that tools such as the FIM help quantify function in a more numeric way, perhaps that is where the directive is leading us?? Terrianne
Ron Carson <[EMAIL PROTECTED]> wrote: Hello Terrianne: I understand what you are saying about third party payers not wanting goals that reflect scores, however, I think their primary concern is about ROM, strength, distance, etc. Do you agree? In fact, CMS just came out with new 'directives' advising the use of outcome measures that are very 'numbers based'. It seems that there must be some way of quantifying progress. Thanks, Ron ----- Original Message ----- From: Terrianne Jones Sent: Wednesday, January 31, 2007 To: [email protected] Subj: [OTlist] COPM Scores as the Goal? TJ> Ron, for years now we have been hearing that third party TJ> payers do not want goals that reflect improvement in scores, but TJ> rather improvment in function. You are correct that an MD or TJ> anybody else other than an OT for that matter would look at the TJ> COPM scores and say "what does that tell me??" I love the COPM and TJ> use it daily in my homecare practice, however I do not include the TJ> numbers in my goals. Instead, I document that I administed the TJ> COPM to help determine which goal areas to focus on from a client TJ> centered approach, but the actual goals I write are functional TJ> such as your second example. TJ> Terrianne TJ> Ron Carson wrote: Hello All: TJ> I just evaluated a patient with multiple medical issues. As part of TJ> the eval, I administered the COPM. The patient scores indicate that TJ> she is dissatisfied with her mobility and self-feeding. She has joint TJ> ROM issues and pain secondary to RA and is mildly depressed because of TJ> her living situation. Here COPM scores are: TJ> Performance Satisfaction TJ> Mobility 5 3 TJ> Feeding 10 5 TJ> So here's my question. TJ> When drafting the patient's plan of treatment what becomes the goals; TJ> 1. Improving the COPM performance and satisfaction scores TJ> 2. Improving the patient's actual mobility and self-feeding. TJ> To put it another way, if we take the mobility issue, should the goal TJ> read: TJ> 1. Patient's COPM mobility scores will improve to 8 and 10 TJ> 1. Patient will safely and independtly ambulate to/from her ALF dining TJ> room using a 4-wheel rolling walker. TJ> I like the concept of using the COPM scores but I can only imagine TJ> what an MD thinks when he reads this stuff. I don't send them the TJ> actual COPM, only my plan of treatment. TJ> Ron TJ> -- TJ> Ron Carson MHS, OTR/L TJ> www.OTnow.com TJ> -- TJ> Options? TJ> www.otnow.com/mailman/options/otlist_otnow.com TJ> Archive? TJ> www.mail-archive.com/[email protected] TJ> ************************************************************************************** TJ> Enroll in Boston University's post-professional Master of TJ> Science for OTs Online. Gain the skills and credentials to propel TJ> your career. TJ> www.otdegree.com/otn TJ> ************************************************************************************** TJ> --------------------------------- TJ> Get your own web address. TJ> Have a HUGE year through Yahoo! Small Business. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ************************************************************************************** --------------------------------- Don't get soaked. Take a quick peak at the forecast with theYahoo! Search weather shortcut. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
