Functional Recovery Questionnaire & Interventions
COHE Community of Eastern Washington is working collaboratively with the Washington State Department of Labor & Industries (L&I) to develop new best practices that span the full period of an injured worker's recovery. As a part of our continual quality improvement process, we are implementing an emerging best practice called the Functional Recovery Questionnaire & Functional Recovery Interventions.
The Functional Recovery Questionnaire (FRQ) is a six-question survey used to help us identify injured workers that are at a high risk of long-term disability. It’s highly-predictive of long-term disability – 36 percent of workers identified as “positive” on the FRQ are disabled one year after injury, compared to 3 percent of workers with a negative FRQ. It is a tremendous tool in identifying what patients have the greatest need of COHE services.
The Functional Recovery Interventions (FRI) are new occupational health best practices that the attending provider should include in initial treatment in addition to regular COHE best practices. It is intended for workers who have a potential for high risk of prolonged disability.
Interventions deal with:
- Active participation in recovery
- Discuss normal recovery
- Work accommodation or job concerns
- Incrementally-increasing activity
- PT/OT referral oversight
- Routine charting of functional status
The FRI is a "tool in the provider's toolbox" available to be used to help injured workers return to health and return to work.
Our health services coordinators (HSCs) identify workers who have been off of work between 10 and 58 days and call them to administer the FRQ. If the score comes out "negative," HSCs continue their regular care coordination activities. If it comes out "positive," the HSCs contact the medical provider to pursue appropriate Functional Recovery Interventions.
After identifying these high-risk injured workers, the providers determine which of the interventions are appropriate based on medical complexity, the availability of work accommodation, etc. Patients have an activity diary available for use and medical providers have a Functional Recovery Interventions tracking sheet for use that is billed separately from usual clinical care.
As of Fall 2015, physician advisors in the COHE Community of Eastern Washington are piloting the FRI within their clinical operations with the goal of expanding the FRI to all COHE providers. If you are interested in learning more about how you can use the FRI to address difficult claim concerns, contact your local health services coordinator or the main COHE office.
L&I is developing and refining tools for implementing FRIs in your practices. Current versions of some of the tools are available here. Revised versions and new materials will be added as they become available.
- Provider's FRI Summary Card
A double-sided summary and flow chart for providers
- FRI Poster
An 11"x17" poster for providers to use as a guide during the FRI process
- FRI Tracking Sheet & Patient's Activity Diary
The FRI tracking sheet for the providers and an activity diary for the patients
- FRI Tracking Sheet
A stand-alone FRI tracking sheet
- PT/OT Referral Form
L&I's optional referral form to use when referring for PT/OT services
- AP Referral Form
L&I's optional referral form to use when referring to another attending provider
- FRI Instructions
L&I's instruction sheet on conducting FRIs
- Provider FRI Billing Guide
L&I's guideline addressing FRI billing