Objective Using AM-PAC “6-Clicks” scores at initial physical therapist and/or occupational therapist evaluation to assess: (1) predictive ability for community versus institution discharge and (2) association with discharge destination (home/self-care [HOME], home health [HHA], skilled nursing facility [SNF], and inpatient rehabilitation facility [IRF]). Methods In this retrospective cohort study, initial “6-Clicks” Basic Mobility (6CBM) and/or Daily Activity (6CDA) t scores and discharge destination were obtained from electronic health records of 17,546 inpatient admissions receiving physical therapy/occupational therapy at an academic hospital between 10/1/15–8/31/18. For objective (1), postacute discharge destination was dichotomized to community (HOME and HHA) and institution (SNF and IRF). Receiver operator characteristic curves determined the most predictive 6CBM and 6CDA scores for discharge destination. For objective (2), adjusted odds ratios (OR) from multinomial logistic regression assessed association between discharge destination (HOME, HHA, SNF, IRF) and cut-point scores for 6CBM (≤40.78 vs > 40.78) and 6CDA (≤40.22 vs > 40.22), accounting for patient and clinical characteristics. Results Area under the curve (AUC) for 6CBM was 0.80 (95% CI = 0.80–0.81) and 6CDA was 0.81 (95% CI = 0.80–0.82). The best cut-point for 6CBM was 40.78 (raw score = 16; sensitivity = 0.71 and specificity = 0.74) and for 6CDA was 40.22 (raw score = 19; sensitivity = 0.68 and specificity = 0.79). 6CBM and 6CDA were significantly associated with discharge destination, with those above the cut-point resulting in increased odds of discharge HOME. The 6CBM scores ≤ 40.78 had higher odds of discharge to HHA (OR = 1.7 [95% CI = 1.5–1.9]), SNF (OR = 7.8 [95% CI = 6.8–8.9]), and IRF (OR = 7.5 [95% CI = 6.3–9.1]) 6CDA scores ≤ 40.22 had higher odds of discharge to HHA (OR = 1.8 [95% CI = 1.7–2.0]), SNF (OR = 8.9 [95% CI = 7.9–10.0]), and IRF (OR = 11.4 [95% CI = 9.7–13.5]). Conclusions “6-Clicks” at physical therapist/occupational therapist initial evaluation demonstrated good prediction for discharge decisions. Higher scores were associated with discharge to HOME; lower scores reflected discharge to settings with increased support levels. Impact Initial 6CBM and 6CDA scores are valuable clinical tools in the determination of discharge destination.

Aims and Objectives:To determine the level of convergent validity of the '6-Clicks' Basic Mobility and Daily Activity with the Bedside Mobility Assessment Tool (BMAT) in patients admitted to a tertiary care academic hospital. Background:Accurately measuring a patient's ability to mobilise during hospitalisation is necessary but can be challenging. Two instruments, the Activity Measure for Post-Acute Care short-form '6-Clicks' and the BMAT, are commonly used to determine patients' mobility levels; however, these instruments have not been psychometrically evaluated together. Understanding the characteristics between these tools can support the process of shared decision making amongst healthcare providers. Design: Retrospective Cohort adhering to the STROBE statement. Methods: Using 13,498 individual patient admissions from an electronic health record, the BMAT score measured closest in time to the '6-Clicks' Basic Mobility and Daily Activity evaluation was collected. Spearman rank correlations with 95% confidence intervals (CIs) were calculated to determine the level of convergent validity between the '6-Clicks' Basic Mobility and Daily Activity with the BMAT. Pairwise correlations were also calculated and stratified by admitting medical service. Results: All correlations for the '6-Clicks' Basic Mobility or Daily Activity summative scores and the BMAT mobility levels were statistically significant and moderately correlated. The weakest correlations were seen within the Orthopaedic admitting service group. Most correlations stratified by admitting service [CVD/Pulmonary, Medicine/ Hospitalist, Other Surgery and Solid Organ Transplant] were moderate. The strongest correlations were seen within the Neuro/Stroke admitting service. Conclusion:Moderate levels of convergent validity exist between the '6-Clicks' and the BMAT in this sample. These findings demonstrate that the construct of patient mobility is not being assessed similarly between the two instruments. | 2049LININGER Et aL.