The “Functional Status Assessment of Seniors in the Emergency Department (FSAS-ED)” tool was specifically developed so occupational therapists can clarify their clients’ functional status when they visit the emergency department. Based on the information collected, the evaluator can make recommendations regarding what type of guidance to provide and follow-up to emphasize, and then forward them to the emergency department’s interdisciplinary team.
The FSAS-ED is an assessment tool in the form of a questionnaire; its development is based on the conceptual framework of the International Classification on Functioning, Disability, and Health (ICF) published by the World Health Organization (OMS, 2001). The FSAS-ED tool:
- Describes how a person functions; that is, what the person does in his or her usual living environment
- Interprets the level of difficulty combined with the amount of help required to perform various activities
- Compares the functional status since the event that precipitated the emergency department visit with the functional status prior to the event
- Describes facilitators or hurdles present in the environment that impact on the person’s functioning
Overall goal of the FSAS-ED:
- Assess a person’s functioning in daily life
Specific goals of the FSAS-ED:
- Document whether it is safe to return home
- Prevent returns home when they are not deemed safe
- Improve safety upon return home
- Identify hurdles and situational facilitators in the patient’s environment
- Identify unmet needs
- Suggest an intervention plan
- Transfer targeted information to the other care continuum providers
The FSAS-ED is designed for:
- Occupational therapists who work in emergency departments in order to help them determine the functional status of their clients during a visit to the emergency department.
The FSAS-ED’s tool target clientele is made up of seniors:
- Who visit the emergency department for a functional limitation issue
- Who are medically stable
- About whom doubt exists regarding the safety of a return home
Summary of FSAS-ED features:
The questionnaire has 40 items divided into three components:
- 23 items that assess activities and participation based on difficulty and help-required scale
- 10 items that assess body functions on a disability scale
- 7 items that assess environmental factors in terms of facilitators or hurdles
The form that serves as a guide to draft the assessment report following the FSAS-ED assessment:
- Is versatile in order to meet clinicians and establishments’ specific needs, particularly given the fact that the part of the document that is retained in the file can be adapted to the practice context of the clinical setting that uses it.
- Was approved and found to be compliant with the standards in effect regarding Ordre des ergothérapeutes du Québec (OEQ) Record Keeping.
FSAS-ED assessment methods:
Scoring is based on the clinical judgment of the evaluator according to:
- the patient’s answers during the semi-structured interview
- the information available from an accompanying close relation
- the evaluator’s own observations
- the medical file
The duration of the assessment ranges from 45 minutes (simple cases) to 90 minutes (complex cases).
FSAS-ED standardization and validation:
Validity of content was confirmed with key informants, a group of experts and also during development studies with seniors who visited the emergency department (Veillette et al. 2009).
- Veillette, N., Demers, L., Dutil, É. and McCusker, J. (2009). Development of a Functional Status Assessment of Seniors visiting Emergency Department. Archives of Gerontology and Geriatrics, 48(2), 205-212. http://dx.doi.org/10.1016/j.archger.2008.01.009
Item analysis (distribution of answers, accuracy of scores between judges and indication of change) confirmed these psychometric properties with 150 seniors who visited the emergency department (Veillette et al. 2009).
- Veillette, N., Demers, L., Dutil, É. and McCusker, J. (2009). Item analysis of the Functional Status Assessment of Seniors in the Emergency Department. Disability & Rehabilitation, 31(7), 565-572. http://dx.doi.org/10.1080/09638280802240332
English translation and validation of the English version of the FSAS-ED (Veillette and al. 2013).
- Veillette, N., Sirois, M.J., Stern, M., Leclair, L. and Struthers, A. (2013, May-June). Knowledge Translation Strategies Promoting the Use of the FSAS-ED. Poster presented at the CAOT conference, Victoria.
Validation of using the FSAS-ED tool with people with cognitive impairment (Robitaille, Veillette and Freeman, 2013).
- Robitaille, J., Veillette, N. and Freeman, A. (2013, May-June). Functional assessment of older people with cognitive disabilities in emergency. Poster presented at the CAOT conference, Victoria.