Therapists' Perceptions of Application and Implementation of AM-PAC "6-Clicks" Functional Measures in Acute Care: Qualitative Study

Background. Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" tools are functional measures used in acute care. No studies have identified reactions and perceptions of therapists in implementing these measures. Objectives. The purpose of this study was to explore therapists' perceptions regarding the application and implementation of AM-PAC "6-Clicks" tools. Design. This study used a qualitative design with thematic analysis. Methods. A convenience sample of 13 physical therapists and occupational therapists participated in semistructured telephone interviews. Interviews were recorded, transcribed, and coded, after which thematic analysis was used to determine common themes. Results. Five themes were identified: (1) unclear purpose, (2) lack of confidence in scoring, (3) too simple for decision making or generalizing patient function, (4) no effect on clinical routine, and (5) potential for communicating patient function across disciplines. Limitations. Participants came from one health care system. A relatively small percentage of staff agreed to participate in this study, and additional interviews might have revealed new themes. Conclusions. As participants in this study implemented the AM-PAC "6-Clicks" tools, they considered the role of the measures, how they fit within the context of practice, and their value. They also were concerned with the accuracy and feasibility of the tools. The tools were accepted as potentially valuable to assist administrative decisions and research; however, they were not perceived as particularly useful for routine patient care. Participants lacked complete confidence in the reliability of their scoring and expressed concern that the scores might be substituted for their clinical decision making. They also felt that the tools were too simple to fully reflect patients' overall function and were not useful alone for discharge planning. Participants believed the tools had the potential to be used for communication among colleagues about patients' physical function.