interrai for Australia and New Zealand? Talking the same language for effective care of older people
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1 interrai for Australia and New Zealand? Talking the same language for effective care of older people
2 interrai basics The interrai method The Australian context Version availability Copyright arrangements Software issues Information distribution
3 interrai instruments interrai instruments are clinical tools to assess individuals with a view to developing an effective care plan The information is recorded in standardised format (Minimum Data Set) The information collected triggers more in depth assessment of selected domains
4 interrai model Assessment Case Mix Minimum Data Set Triggers Care planning protocols Outcome Measurement Scales Quality Indicators
5 interrai instruments interrai instruments SCREENERS Self-reliance Protocol (community care) Contact assessment* Emergency room* Acute care* INSTRUMENTS Long term care facility Assisted living (hostel) Home care Community health assessment Mental health Community mental health Acute care Post-acute care Palliative care * In development
6 Take up processes Government mandate Service / practitioner choice
7 Australian context Residential care Attempts to encourage systematic assessment Casemix issues Aged Care Assessment Program Relationship with residential care; growing paperwork Home care Multiple agencies, variety of jurisdictional agencies Acute care Clinically driven screening Some casemix arrangements Disability services General practice 75+ assessment HealthConnect Event summaries in aged care?
8 Opportunities for reform Assessment, QIs, benchmarking in residential care (LTCF) Assessment, care planning in ACAS (HC / CHA) Assessment care planning in community care (HC / CHA) Comprehensive assessment in acute care / post-acute care (AC / PAC)
9 Desirable attributes of clinical information systems in community care in Australia
10 Instruments matched to case complexity Common core items across instruments Screeners to assist triaging Common instrumentation for ACAT, community provider agencies and residential care Casemix, quality indicators and administrative reporting to be byproducts of clinical data sets
11 Care domains Acute hospital interrai AC Community interrai HC & CHA Post-acute hospital InterRAI PAC Palliative care interrai PC Residential care interrai LTCF
12 Application of interrai model to ACAT environment Assessment External reporting (ACCR/MDS) Summary reports & scales Minimum Data Set Referral generation Triggers Care planning protocols Casemix & resource allocation Internal quality control
13 The interrai HC for ACAT Assessment Instrument size comparable Good domain matching Many items in the ACAP MDS & the ACCR can be mapped directly from the interrai - HC interrai - Home Care Comprehensive Geriatric Assessment & Care Planning for Home Care
14 The interrai-cha and -HC interrai Community Health Assessment Short 14 domains 34 questions ~ 85 data items interrai Home Care Comprehensive 16 domains 59 questions ~ 230 data items
15 Framework for Community Care Request for community care interrai interrai screener screener Self-reliant? Self-reliant? Packaged care Yes No interrai-cha interrai-cha interrai-hc interrai-hc Basic care Unexpected complexity interrai-functional interrai-functional supplement supplement Early intervention & information
16 Current Australian Projects High needs project Assessment using the interrai HC (Western Health Melbourne) 2004 Participation in international reliability studies for rd generation instruments (AC / PAC / HC) (Qld, Vic) RCT of IP acute geriatric assessment using the RAI-AC (Mater / Townsville) due end 2004 GeriScan Geriatric Assessment in a Box (Qld) current Coordinated care trial RAI-Home Care (Melbourne) Pilot testing of interrai PAC (Qld) 2005 Development of a delirium screener using the interrai AC items (in progress) due 2005 Development of a screener for geriatric assessment using the interrai AC due 2006
17 Versions interrai Australia is promoting new suite only Data sets released April 2005 Manuals due September 2005 Scales, triggers and CAPs late 2005 Materials available from interrai Australia
18 Copyright & licencing Why copyright? Content control Support revenue generation Licences Short-term, research, demonstration (interrai Australia) Long-term, larger scale (interrai international) Financial arrangements interrai is not-for-profit Royalties are charged to software vendors and publishers No direct charges to users
19 Software vendors Listing available on interrai Australia website
20 Information distribution Mailing list interrai Australia News list interrai Australia News interrai international News will be relayed to Australian subscribers
21 Talking the same language for effective care of older people
Talking the same language for effective care of older people
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