AMPS: Enhancing occupational
therapy at Hamilton Health Sciences
What are the key indicators of a person’s ability to live and care for themselves independently?
Is it their capacity to dress themselves in the morning? To prepare their own meals? To move about with ease?
Assessment can be a tricky business, and many assessment tools rely heavily on the observations and judgment of the therapist, whose task is challenged by the fact that the abilities and needs of each patient are unique and often quite complex.
It is often the role of an occupational therapist (OT) to make this kind of qualitative assessment of people’s lives to determine what kind of help is needed and to create an action plan. And they often have to take that assessment down to a finer point.
“Often, the role of the OT is quite abstract,” says Susan Pettit, an occupational therapist in the Complex Medicine Rehabilitation Unit (CMRU) at Juravinski Hospital in Hamilton, Ontario. “OTs must take into account what is important to each client before being able to help them overcome or compensate for a change in their abilities.”
Over the last few years, Susan has been a strong advocate for the standardized Assessment of Motor and Process Skills (AMPS), an observational assessment method that allows OTs to measure the quality of an individual’s motor and process performance as they carry out activities of daily living. It’s a comprehensive method that provides the therapist with a more refined, meaningful understanding of an individual’s capabilities.
“The AMPS is unique in that it can be done with persons of all ages, with any diagnosis, in their own language, and it uses activities that are familiar,” says Susan. “Other assessments are often geared to identify a deficit but do not predict how that deficit will affect function.”
AMPS is distinct in that it rates performance of both motor and process skills against an established cutoff point. Raw data is entered into a computer system, which plots the information on a scale that shows whether the individual falls above or below the cutoff for a specific task, and whether they perform within the normative range for healthy people of the same age. The database is comprised of data that has been standardized internationally and cross-culturally on more than 100,000 subjects, providing an objective basis for measuring change over time.
AMPS was developed more than 20 years ago in Sweden, and has since been offered as a course in more than 25 countries around the world. In order to administer AMPS, OTs must complete a five-day training workshop, and are required to administer the test on 10 people following the course. This testing is part of a calibration process that allows assessment scores to be adjusted according to the severity of the rater, reducing bias and allowing for more consistent results.
“The AMPS tool provides the health care team, as well as patients and their families, with valuable information regarding an individual’s motor and processing capabilities,” says Jennifer Henderson, chief of occupational therapy at Hamilton Health Sciences. “It can be a relief for families to have strengths and weaknesses clearly identified, and practical strategies provided that will help them support their loved ones as they transition back into the community.”
At Hamilton Health Sciences, there are more than 85 occupational therapists working in outpatient and inpatient areas. To date, 20 have been trained in AMPS. In an effort to increase uptake of the program, Susan and Jennifer have been successful in bringing the AMPS workshop to Hamilton. The first workshop was offered by Hamilton Health Sciences in October of 2011 to OTs both internal and external to the organization. During the week of April 16-20, 2012, Hamilton Health Sciences hosted its second AMPS course at St. Peter’s Hospital
“To obtain AMPS training, an OT must often travel to another province or even another country,” says Jennifer. “By offering the course right here in Hamilton, OTs are able to enhance their practice at a lower cost and focus on the interventions that they know will make the biggest difference in the lives of their patients and their families.”