Translating measures across the continuum of care: using Rasch analysis to create a crosswalk between the Functional Independence Measure and the Minimum Data Set.

Setting-specific outcome measures present a major barrier to monitoring patient progress across the continuum of care. This study demonstrated Rasch analysis for the creation of a crosswalk between the Functional Independence Measure (FIM), which is used in inpatient rehabilitation, and the Minimum Data Set (MDS), which is used in skilled nursing facilities. To create the crosswalk, we used data from a sample of 236 patients from four Department of Veterans Affairs' facilities who had had both the FIM and the MDS administered within 7 days. The combined FIM-MDS analysis showed good internal consistency (Cronbach alpha = 0.94), with 21 of the 26 items showing acceptable fit statistics. FIM and MDS raw scores correlated at -0.81 and the measures, corrected for scale direction, correlated at 0.78. Future validity testing will be necessary to determine the accuracy and applicability of the crosswalk.