Functional Assessment: Process and Product

Abstract

Functional assessment is both a process, eliciting information, and a product, a profile of patient performance. Because patient functional status affects payment and change in status (outcome) is a proxy for quality, there has been increasing emphasis on functional assessment accuracy and on assessment techniques. This emphasis on data collection and data accuracy has divorced functional assessment from its primary purpose: care planning. Effective functional assessment should yield a profile of the patient’s performance of daily activities, which guides care planning. Assessment of performance must identify the factors influencing performance, not solely the current performance status. Functional performance is a dynamic interaction of person, environment, and activity. When assessment is relinked to care planning and clinical reasoning is directed toward patient performance, functional assessment becomes not an end in itself but a starting point to achieve outcomes that make a difference in the daily lives of patients.