The Kansas University Hospital Physical Therapy Acute Care Functional Outcomes Tool (KUH Tool) is designed to assess functional improvements in hospitalized patients. This article provides a guide on how to score the KUH Tool and understand its components.
Understanding the KUH Tool
The KUH Tool addresses a need for a sensitive measure of functional progress in acute care settings. Traditional tools like the Functional Independence Measure (FIM) may not capture subtle improvements in patients unable to tolerate intensive rehabilitation. The KUH Tool offers a more detailed assessment, particularly for basic mobility tasks crucial for a safe discharge home.
Scoring the Four Domains of the KUH Tool
The KUH Tool assesses four key areas of functional mobility, each scored on a scale of 0 to 7:
1. Bed Mobility
This section evaluates the patient’s ability to move in bed, including transitioning from lying down to sitting on the edge of the bed.
- 7: Complete independence
- 6: Modified independence (use of assistive devices, safety considerations, increased time)
- 5: Supervision (set-up or verbal cues required)
- 4: Minimal assistance (patient performs 75% of the task)
- 3: Moderate assistance (patient performs 50-74% of the task)
- 2: Maximum assistance (patient performs 25-49% of the task)
- 1: Total assistance (patient performs less than 25% of the task)
- 0: Cannot assess or activity not appropriate
2. Transfers
This section assesses the patient’s ability to move from one surface to another, specifically from bed to chair. The scoring criteria are identical to Bed Mobility.
3. Gait
This domain evaluates the patient’s ability to walk on level surfaces, with or without assistive devices. The scoring criteria are the same as Bed Mobility and Transfers.
4. Walking Distance
This section measures how far the patient can walk, providing a more granular assessment of ambulation than simply gait quality.
- 7: > 201 feet
- 6: 151-200 feet
- 5: 101-150 feet
- 4: 51-100 feet
- 3: 31-50 feet
- 2: 11-30 feet
- 1: 1-10 feet
- 0: Cannot assess or activity not appropriate
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Calculating the Total Score and Change in Score
Each of the four domains receives a score from 0 to 7. These scores are added together to obtain a total score, ranging from 0 to 28. The KUH Tool is administered at the initial and final physical therapy visits. The change in score is calculated by subtracting the initial score from the final score, reflecting the patient’s functional improvement.
Using the KUH Tool in Practice
The KUH Tool provides valuable data for documenting patient progress, justifying the need for continued skilled physical therapy services, and demonstrating the effectiveness of interventions. It’s a practical tool for acute care physical therapists seeking to quantify functional gains in their patients.
Conclusion
The KUH Tool is a sensitive and practical assessment for measuring functional outcomes in acute care. By understanding its scoring system, clinicians can effectively utilize this tool to document patient progress, advocate for necessary services, and contribute to quality improvement initiatives.
