The Rehab in the Home (RITH) dataset
The Rehabilitation In The Home (RITH) data collection is AROC newest collection launching on January 15th 2024. This collection has been specifically designed to capture the functional outcomes achieved by inpatient substitution RITH programs and also provides them with their own benchmarking group. Watch the RITH launch webinar here.
- Benchmarking and quality improvement
- Data collection forms
- Outcome measures
- How to collect the RITH dataset
- Join AROC data collection
AROC will be running national benchmarking and networking events for RITH members. These events will serve as opportunities for services to review the data and network, as well as provide feedback to AROC around this newly developed dataset.
Yearly service meetings with an AROC Improvement Facilitator are also available to members to review their data. These meetings allow services to focus in on their data and reports to see where they are doing well and where best to target quality improvement activities.
Functional Independence Measure (FIM)
The FIM is used to measure functional improvement during the rehabilitation episode in the inreach and inpatient data collections. It was included also in the RITH collection as this allows for comparison to these other admitted models of care. The FIM instrument assesses an individual’s activity limitations and their need for assistance (or burden of care) to perform basic life activities. To ensure quality and accurate FIM data is collected, assessors of the FIM must be trained and credentialed. For further information on FIM Training & credentialing.
Functional Assessment Measure (FAM)
The Functional Assessment Measure (FAM) does not stand alone but adds 12 FAM items to the FIM, specifically addressing cognitive and psychosocial function. FAM items are rated on the same 7-level scale as the FIM items although the scaling structure of the FIM does not always lend itself to the more abstract nature of the FAM items.
The original FAM items were developed by Santa Clara Valley Medical Center(SCVMC), San Jose, California. In 1996 the UK FIM+FAM users group adapted the FAM items to produce a UK version, in collaboration with SCVMC.
The FAM including the extended activities of daily living (EADLs) section were included in the RITH data collection to enable the measures of high level functional activities that are often the focus of these programs. The FAM does not require credentialing, but AROC has provided some training resources and a manual in the resources section below.
The EQ-5D-5L is a patient reported health related quality of life measure. This measure allows patients to quantify and have reported their view of how their health has changed over the course of the RITH program.
Two mobility measures are included in the RITH data collection (Timed up and go and 6m walk test). These measures allow for objective measurement of mobility changes during the programs. These measures can also be used across datasets in the future to map the progress of patients throughout their rehabilitation journey.
Depression, Anxiety and Stress Scale 21 (DASS 21)
The DASS21 has been added to the RITH data collection to facilitate the routine screening of mood and mental health. While not a comprehensive assessment the DASS21 can highlight where further assessment and/or referral may be required as well as providing service an overall picture of the mood of their cohort.
Clinical Frailty Scale
The Rockwood clinical frailty scale measures the premorbid frailty of all patients entering RITH programs. Frailty levels may impact rehabilitation outcomes and may require specific interventions to limit/reverse the its effects.
Length of stay (LOS)
The LOS of a RITH episode is the number of days on which care has been provided. It is calculated as the RITH rehabilitation end date (date discharged from rehabilitation service) minus the RITH rehabilitation start date (date admitted to the rehabilitation service). Many RITH rehabilitation patients will also have had an acute and/or subacute LOS prior to their RITH rehabilitation episode – this is not included in the RITH rehabilitation LOS.
If you are a new AROC RITH service please contact email@example.com to set up a meeting with an AROC improvement facilitator to discuss your data collection processes.
AROC RITH Data Dictionary
The AROC RITH Data Dictionary provides information on the definition and purpose of each data item as well as examples and guidelines. This is a vital document to ensure that services are collecting the data items correctly. If after reviewing the data dictionary you are still unsure about a particular data item, please contact firstname.lastname@example.org
Data dictionaries are available for clinicians, analysts and developers.
AROC Impairment Coding Guidelines
The AROC impairment code should reflect the primary reason for the patient’s current episode of rehabilitation care. It is best practice for the impairment code to be allocated by the rehabilitation physician (or physician with an interest in rehabilitation) or an experienced clinician. A non-clinical staff member should never allocate an impairment code. AROC recommends using the impairment coding guidelines, which include examples of aetiologic diagnoses that could underpin each impairment. This list is not exhaustive.
Rockwood Clinical Frailty Scale
The Rockwood Clinical Frailty Scale is used to record the patient’s level of frailty prior to their injury (or exacerbation of impairment), resulting in this episode of rehabilitation care.
Guideline for the collection and coding of COVID-19 AROC data
In July 2022 AROC introduced new COVID conditions impairment codes, COVID comorbidities and a COVID complication. This complements the already established AROC National COVID-19 rehabilitation adjunct data collection. AROC recommends using the guideline and decision tree below to assist in the correct coding and completion of this COVID-19 specific data.
Suspension of rehabilitation treatment
This document defines and explains AROC “suspensions” in detail.
The general rule is that where a patient’s rehabilitation treatment is suspended for a period, and the patient then comes back onto the same program of rehabilitation (that is, a new program is not required to be developed), then the period of absence is counted as a suspension. The length of suspension of treatment does not matter, as long as the patient comes back onto the same program of rehabilitation.
Where a patient’s rehabilitation treatment is suspended for a period, and on their return, a new rehabilitation program is required, then the period of absence IS NOT counted as a suspension. Rather the patient should be discharged and a new episode commenced.
Rehabilitation Care Plan - Anywhere Hospital
This is a proforma of an MDT plan to be used by the rehabilitation team to document a set of agreed goals and action plans/initiatives for a patient. It is best practice for the rehabilitation physician (or physician with an interest in rehabilitation) and the rehabilitation team to establish the MDT plan in collaboration with the patient (if possible) asap, but at most within 7 days of admission. Additionally, for the plan to be reviewed on a regular basis and kept in the patient medical record.