Improving the Quality of Long‐Term Care with Better Information

Mor, Vincent

doi:10.1111/j.1468-0009.2005.00405.x

Cited by 118 publications

(51 citation statements)

References 98 publications

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“…15,16 In addition, MDS data has undergone extensive validity and reliability testing. 26,36,37 Individual assessment items in such areas as functional and cognitive status and resident diagnoses have also demonstrated reliability and validity in several large scale studies undertaken in multiple nursing facilities. 38–41 …”

Section: Discussionmentioning

confidence: 99%

Not So Black and White: Nursing Home Concentration of Hispanics Associated with Prevalence of Pressure Ulcers

Gerardo

Teno

Mor

2009

Journal of the American Medical Directors Association

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Objective To examine the association between the nursing home (NH) concentration of Hispanics and prevalence of pressure ulcer. Design Secondary data analysis using data from the national repository of the 2000 Minimum Data Set (MDS) and On-Line Survey Certification and Reporting (OSCAR) data. We used a multivariate logistic model, with the Huber-White correction to account for clustering of persons within a nursing facility, to examine the association of Hispanic NH concentration with the prevalence of pressure ulcers, after adjusting for resident level characteristics. Setting Five states with a high population of Mexican-Americans (California, New Mexico, Arizona, Colorado, and Texas). Participants A total of 74,343 persons (9.26% black, 11.28% Hispanic, 79.46% non-Hispanic white) in a NH located in 1 of these 5 states during the last quarter of 2000. Measurements The prevalence of Stage II–IV pressure ulcers was examined in the last quarter of 2000. Stage II–IV pressure ulcers, resident demographics, and medical illness data were documented by nursing staff on the MDS. Results Hispanics and non-Hispanic blacks had a higher prevalence of pressure ulcers than non-Hispanic whites (7.60%, 9.71% and 12.10%, respectively). A facility’s concentration of Hispanic residents was associated with prevalent pressure ulcers after adjustment for resident characteristics. Conclusions Residents in nursing homes in which there is a higher concentration of Hispanic residents are more likely to have a pressure ulcer.

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Section: Discussionmentioning

confidence: 99%

Not So Black and White: Nursing Home Concentration of Hispanics Associated with Prevalence of Pressure Ulcers

Gerardo

Teno

Mor

2009

Journal of the American Medical Directors Association

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“…Unmet needs were explained by an unrelevant fit between the comprehensive assessment and a non-systematic care planning procedure [37]. This population is characterized by higher resource utilization, and using the RAI instruments could reduce hospitalization from LTCF [7]. …”

Section: Implementation Of the Interrai Instruments In Francementioning

confidence: 99%

“…It should include a core set of items providing a comprehensive picture of each clients with a direct impact on relevant care plan decisions [5]. A comprehensive needs assessment and care planning across multiple care settings has a positive impact on health parameters and care pathways [6], and has been shown to improve the quality of care [7], resource access [8] and overall performance of the health care system for the elderly population [9]. …”

Section: Introductionmentioning

confidence: 99%

Implementation of a Standardized Comprehensive Assessment Tool in France: A Case Using the InterRAI Instruments

Stampa

Cerase²,

Bagaragaza

et al. 2018

International Journal of Integrated Care

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Background:The improvement of quality of care requires a standardized and comprehensive assessment tool but implementation is challenging.Purpose:We have reported on the development of the interRAI instruments in France from the onset to the mandatory use at the national level. We also have identified in the literature and in practices, incentives and barriers for the implementation of this integrated clinical information system in long term care.Results:Three periods in the interRAI instruments development were identified over the last twenty years. The first one was a research approach about improving quality of long term care. The second one was an experimental clinical use into an integrated care model with case management. The third one was a call for tenders issued by a French national agency, and the choice to use the interRAI-HC (Home Care) for all case managers. The main incentives and barriers that were identified include the national context, the target population, the providers involved and the impact on their practice, the interRAI instrument characteristics, training and leadership.Conclusion:This historical overview of the development of interRAI instruments in France gives health care organizations pertinent information to guide the implementation of a standardized and comprehensive assessment tool.

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“…The RAI 2.0 is designed as a comprehensive assessment to be used as part of normal clinical practice, and assessments are intended to be done by trained health professionals working as part of a multidisciplinary team. In addition to care planning [12], other applications include case-mix based funding [13], quality indicators [14,15], and outcome measurement [16]. These multiple applications for multiple audiences have meant that many stakeholders in continuing care have begun to look to these data as an important source of information for a variety of decisions.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of data quality in Canada’s Continuing Care Reporting System (CCRS): secondary analyses of Ontario data submitted between 1996 and 2011

Hirdes

Poss

Caldarelli

et al. 2013

BMC Med Inform Decis Mak

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BackgroundEvidence informed decision making in health policy development and clinical practice depends on the availability of valid and reliable data. The introduction of interRAI assessment systems in many countries has provided valuable new information that can be used to support case mix based payment systems, quality monitoring, outcome measurement and care planning. The Continuing Care Reporting System (CCRS) managed by the Canadian Institute for Health Information has served as a data repository supporting national implementation of the Resident Assessment Instrument (RAI 2.0) in Canada for more than 15 years. The present paper aims to evaluate data quality for the CCRS using an approach that may be generalizable to comparable data holdings internationally.MethodsData from the RAI 2.0 implementation in Complex Continuing Care (CCC) hospitals/units and Long Term Care (LTC) homes in Ontario were analyzed using various statistical techniques that provide evidence for trends in validity, reliability, and population attributes. Time series comparisons included evaluations of scale reliability, patterns of associations between items and scales that provide evidence about convergent validity, and measures of changes in population characteristics over time.ResultsData quality with respect to reliability, validity, completeness and freedom from logical coding errors was consistently high for the CCRS in both CCC and LTC settings. The addition of logic checks further improved data quality in both settings. The only notable change of concern was a substantial inflation in the percentage of long term care home residents qualifying for the Special Rehabilitation level of the Resource Utilization Groups (RUG-III) case mix system after the adoption of that system as part of the payment system for LTC.ConclusionsThe CCRS provides a robust, high quality data source that may be used to inform policy, clinical practice and service delivery in Ontario. Only one area of concern was noted, and the statistical techniques employed here may be readily used to target organizations with data quality problems in that (or any other) area. There was also evidence that data quality was good in both CCC and LTC settings from the outset of implementation, meaning data may be used from the entire time series. The methods employed here may continue to be used to monitor data quality in this province over time and they provide a benchmark for comparisons with other jurisdictions implementing the RAI 2.0 in similar populations.

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Improving the Quality of Long‐Term Care with Better Information

Cited by 118 publications

References 98 publications

Not So Black and White: Nursing Home Concentration of Hispanics Associated with Prevalence of Pressure Ulcers

Not So Black and White: Nursing Home Concentration of Hispanics Associated with Prevalence of Pressure Ulcers

Implementation of a Standardized Comprehensive Assessment Tool in France: A Case Using the InterRAI Instruments

An evaluation of data quality in Canada’s Continuing Care Reporting System (CCRS): secondary analyses of Ontario data submitted between 1996 and 2011

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