SERIAL FUNCTIONAL ASSESSMENT - CHANGING THE CULTURE OF THE HOSPITAL

Objective functional skills assessment gives a rational basis for the revolution in health care. Cardinal numerical data define individual p atients' needs and refocuses energy on them, specifies remediable defi cits and their treatment, and then evaluates outcome. Not surprisingly , serial functional assessments correlate well with functional status at discharge, and the closely related length of hospital stay. Therefo re, serial functional assessments may be used to predict inpatient and outpatient resource utilization. This tool, as sensitive as it is pow erful, can change the culture of hospitals and aftercare sites, giving backbone to peer group leaders and even guiding educational reform. B ecause chronic disabilities are by definition cumulative, it is the fi xed-income geriatric patients who will benefit most from the justice i nherent in this type of approach.