Tree of Life Services strives to provide the best possible care to its residents. When doing so, Tree of Life focuses on assisting individuals improve their functional and treatment outcomes as well as overall quality of life. These goals are achieved through a variety of coordinated care and rehabilitation efforts by dedicated staff. In order to determine the effectiveness of interventions, Tree of Life collects information to evaluate how such efforts impact the resident. This is done through formal, standardized outcomes’ measurement as well as soliciting input from stakeholders.
The main outcome tracked with our clients is the Mayo-Portland Adaptability Inventory (MPAI), which assesses common effects stemming from brain injury. This information can be used to assist with planning rehabilitation interventions and clinical decision making. The items on the MPAI assess physical abilities, emotional adjustment, social interactions, and community participation. The MPAI has been shown to have well documented statistical properties allowing its use in both research and clinical settings. Our data for the last 5 years indicates that our transitional clients all had significant improvement in their scores with an overall t-score change of 12.
In 2014, Tree of Life Services (TOLS) started collecting outcomes data for residents in the Transitional Rehabilitation program using the Mayo-Portland Adaptability Inventory – 4 (MPAI). MPAI data is collected two weeks after admission and following discharge. Transitional program outcome data show residents on average have all made improvements in all areas assessed during their rehabilitation stay at TOLS.
| Total MPAI score | Ability
Ssubscale |
Adjustment Subscale | Participation Subscale |
| 10 T-score point improvement | 6 T-score point improvement | 8 T-score point improvement | 8 T-score point improvement |
In 2014/2015 TOLS started collecting outcomes data for residents in the long-term supported living program (LTSLP) using the (MPAI). Data is collected annually and compared to the previous year’s scores. MPAI data has been collected of 18 LTSLP residents since inception of MPAI data collection. The results demonstrate that, on average, improvements have been made in all areas assessed albeit at a more modest level. It should be noted that many of the individuals in the LTSLP are many years post injury and while continued gains in functioning are sought, programming emphasizes enhancement in in quality of life, reductions in morbidity, and maintaining levels of functioning.
| Total MPAI score | Ability
Subscale |
Adjustment Subscale | Participation Subscale |
| 2 T-score point improvement | 2 T-score point improvement | 3 T-score point improvement | 2 T-score point improvement |
The MPAI scores represent T-score, which have a mean of 50 and a standard deviation of 10.
The Functional Autonomy Rating System (FARS), Disability Rating Scale (DRS), Rancho Los Amigos Scale (RLAS) and Coma Recovery Sacle – Revised (CRS-R) in patients with disorders of consciousness (DoC) are also relied upon to assist in tracking functional status.
In addition to objective measurement of progress, Tree of Life is also interested in obtaining the feedback of individuals we serve. To this end, Tree of Life obtains satisfaction surveys from the residents we serve, family members/significant others, and payer sources. This information is used to facilitate ongoing program enhancements and improvements. If you have any question about our outcomes, please feel to contact us.
Citation
Malec, J. (2005). The Mayo-Portland Adaptability Inventory. The Center for Outcome Measurement in Brain Injury. http://www.tbims.org/combi/mpai.