1. AlphaFIM® Instrument Guided Self Study updated July 2013
Central East Stroke Network
June 2009
AlphaFIM® Instrument Guided Self Study updated July 2013
Self Study for AlphaFIM® Assessors

2. Note to Users
AlphaFIM and FIM are trademarks of Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc. (UDSMR). The UDSMR copyrighted materials contained herein have been reproduced with the permission of UDSMR
This resource is not intended to replace the required training established by UDSMR but to be a complimentary resource for clinicians.

3. Ontario Implementation of AlphaFIM® Instrument
Ontario Stroke System negotiated special regional licenses with UDSMR.
Under this license, use for STROKE PATIENTS ONLY.
Provincial data collection strategy recommends the AlphaFIM® Instrument to be completed on people with stroke on Day 3 (Day 0 is defined as day of admission to the acute care hospital setting).

4. UDSMR Training Resources
AlphaFIM® Instrument Guide
Helpful Hints for Rating the AlphaFIM® Instrument
The AlphaFIM® Case Study Booklet
Current versions are available on the
AlphaFIM® software portal.
How can you access them?
Sign in to the portal at with facility code, username and password. Click on “help” on the left side of the page.

5. AlphaFIM® Instrument Guide
Chapter 1: Introduction to AlphaFIM® Instrument
Chapter 2: Uses of the AlphaFIM® Instrument
Chapter 3: Implementation and Rating Overview
Chapter 4: Specific Rating Instructions
(note Ontario specific information in the following slides)
General Rating Rules
Descriptions and Ratings of 8 items

6. Chapter 1 – Key Points
AlphaFIM® Instrument provides a means of measuring patient disability and functional status in the acute care setting.
Abbreviated version of FIM®
Six items
Patients who walk less than 150 ft
Patients who walk 150 ft or more
1. Eating 2. Grooming 3. Bowel Management 4. Transfers: Toilet 5. Expression 6. Memory
1. Transfers: Bed, Chair 2. Locomotion: Walk 3. Bowel Management 4. Transfers: Toilet 5. Expression 6. Memory

7. Chapter 2 – Key Points AlphaFIM® Instrument uses include:
Preadmission screening for transfer to rehab
Decision regarding discharge from acute care
Outcome measure

8. Chapter 3 – Key Points
The FIM® scoring levels contained herein are copyrighted by Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc. ("UBFA" ) and have been reproduced with permission. All marks associated with FIM are owned by UBFA.  All rights reserved.

9. Chapter 4 – Key Points General Rating Rules:
Begin by determining ability to walk 150 feet or more.
Read definitions for each item carefully.
Record actual performance, not capacity.
Use the lowest rating.
Use the best available information.
Do not leave any items blank.

10. Chapter 4 – Key Points Specific Rating Instructions: Description
Rating Guidelines
Definition for each rating level

11. Rating Instructions Pages 11 - 21
Eating
Grooming
Bowel Management (see supplemental guidelines)
Transfers: Toilet
Transfers: Bed, Chair
Locomotion: Walk
Expression
Memory

12. Suggestions for becoming an accurate AlphaFIM® Instrument Assessor
Use all of your resources for accurate rating:
AlphaFIM® Instrument Guide
Helpful Hints for Rating the AlphaFIM® Instrument
Bowel Management Guidelines
Remember:
AlphaFIM® Instrument is a measure of burden of care.
Assess actual performance, not capacity.

13. Practice! Use the “AlphaFIM® Case Study Booklet” for practice before writing your mastery test.

14. AlphaFIM® Instrument Website Portal
Chapter 5: AlphaFIM® Calculations
Chapter 6: Using the AlphaFIM® Website

15. What is the next step?
After scoring the patient on the 6 items you must complete data entry to obtain the projected FIM® scores.

16. Website Data Entry www.udsmr.org
Select "Software Portals"

17. Website Data Entry
Select “AlphaFIM Software“ or click on the icon below

18. Website Data Entry
Complete Login Info

19. Website Data Entry
Click on “Add” button
in the Information area

20. Website Data Entry Enter facility identifier into “Patient ID” field
Enter the Birth Date
(mm/dd/yyyy)
Enter the Assessment date.
All other fields can be left blank
Enter facility identifier into “Patient ID” field
DO NOT ENTER PATIENT
IDENTIFYING INFORMATION!

21. Website Data Entry Scroll down.
Use the drop down menu to answer the question: “Has the patient been observed walking 150 feet or more?”
Note that items to score change depending on your response to this question.
(Compare with the slide on the next screen.)

22. Website Data Entry Observe how items to score
have changed with a “yes” answer.
(Compare with the slide on the previous screen.)

23. Website Data Entry Enter the ‘Raw Ratings’ of the 6 items
you have scored using the drop down menus

24. Website Data Entry After entering the 6 item scores,
Projected scores are now calculated
After entering the 6 item scores,
click on the orange ‘Calculate’ button

25. Option to print out website calculations or manually record them
Website Data Entry
Option to print out website calculations or manually record them
Go to the top of the page
Click on the ‘Print’ button.

26. Printout Double check that all values were entered correctly.
Ensure it has printed.
Addressograph or write the patient name
or health record number on the printed sheet.
Record the data on your hospital approved form. OR

27. Website Data Entry Then cancel or close. DO NOT SAVE.
Do not leave any patient identifiers in the system.

28. Website Data Entry
Click on Sign out

29. If you accidentally save …
If you accidentally save, your screen will show an entry similar to the above after you close.

30. If you accidentally save …
A popup will ask if you are sure you want to delete the record. Click on “OK”
Highlight by clicking on the entry. Then click on “Delete”.

31. Options for Documentation

32. Sample Chart Note
AlphaFIM® Instrument completed today. Raw scores as follows: eating – 4, grooming – 4, bowel management – 2, transfers: toilet – 3, expression – 7, memory – 6, projected raw motor score - 39, projected raw cognitive score - 32, help needed - 2 to 3 hours Signature

33. Chart Note - Sticker

34. Approved Chart Forms

35. Electronic Health Record (sample 1)

36. Electronic Health Record (sample 2)

37. Questions?
Contact your regional AlphaFIM® Instrument Lead