Contacts Editor:
Len Gray
Please send feedback to Joanna Kho
:: |
|
|
|
From the Editor
In this newsletter, we report on exciting research findings, new research opportunities, and new developments within interRAI. These reports reflect the scope of the international effort that drives interRAI to develop the best available comprehensive assessment systems. interRAI had its beginnings in aged care, but after more than a decade of development, it is now applying its techniques across the entire age spectrum, with work on child and youth assessment systems advancing rapidly. interRAI's global reach is highlighted by the decision of the government of New Zealand to require the use of the interRAI Long-Term Care Facilities Assessment System to all long-term care facilities.
Len Gray
Editor, interRAI
|
|
News
Professor John Hirdes Receives Canadian Queen Elizabeth II Diamond Jubilee Medal
In October 2012, interRAI Fellow Dr. John Hirdes was awarded the Queen Elizabeth II Diamond Jubilee Medal for his leadership in the development and adoption of the interRAI standardized assessment tool for family caregivers and the Method for Assigning Priority Levels in home care. These tools enable the delivery of high-quality home care and community care services across Canada.
Dr. Hirdes is a professor and Ontario Home Care Research and Knowledge Exchange Chair in the School of Public Health and Health Systems, University of Waterloo, Ontario, Canada.
The commemorative medal marks the sixtieth anniversary of Her Majesty Queen Elizabeth II's accession to the throne as queen of Canada, an occasion marked only once before by her great-great-grandmother, Queen Victoria, in 1897. A select group of Canadians across the country were honoured with this award to recognize their significant contributions and achievements to their communities and Canada.
Medal recipients included individuals involved in supporting family caregivers, undertaking research and knowledge dissemination, stimulating innovation in home and community care, and championing vulnerable individuals across Canada. Through their collective involvement in advancing home and community care, Canada can achieve a vision of integrated health and wellness that provides accessible, responsive services that enable people to safely stay in their homes with dignity, independence, and quality of life.
|
|
Use of the interRAI LTCF Assessment System Becomes Mandatory in New Zealand
The New Zealand government recently announced that use of the interRAI LTCF Assessment System will become mandatory in aged residential care as of July 2015. By June 2014 all aged residential facilities in New Zealand will be participating in the roll-out of the assessment tool.
The assessment will assist nurses in aged-care facilities in providing quality care for residents by supplying a comprehensive clinical assessment of needs that supports the development of tailor-made care plans.
New Zealand Associate Health Minister Jo Goodhew noted that comprehensive clinical assessment will provide opportunities to support continuous quality improvement in aged care. "The Auditor General's September 2012 report, Effectiveness of Arrangements to Check The Standard of Services Provided By Rest Homes, emphasises the importance of comprehensive clinical assessment in monitoring the quality of care for older people."
The roll-out in aged residential care follows the successful implementation of interRAI home care assessments for clients of home-based support services completed in 2012.
|
|
Australian Trial to Examine Benefits of interRAI LTCF Assessment System-Supported Telehealth Intervention in Long-Term Care
The benefits of geriatrician-supported comprehensive geriatric assessment (CGA) in long-term care facilities are uncertain, particularly if delivered at a distance through telehealth. Researchers at the University of Queensland, Australia, recently secured substantial funding from the Australian National Health and Medical Research Council to test a model of CGA delivered to facilities via a suite of telehealth strategies. The model under scrutiny includes:
* Standardized assessment using the interRAI LTCF Assessment System at admission to the facility
* Geriatrician review of the assessment online and by video consultation
* Regular attendance by the geriatrician (via video) to support assessment, care planning, and follow-up
* Protocols for risk assessment and mitigation, medication review, and advance care planning
* Facilitated access to a wide range of other specialist capabilities through telehealth
The project, led by interRAI Fellow Professor Len Gray, will examine the effectiveness of the intervention to reduce utilization of external health services by residents in long-term care. These services include visits to emergency departments, hospital admissions, and visits to specialists in ambulatory clinic settings. It will also evaluate effects on quality of care, appropriateness of medication use, and costs.
The design is a pragmatic randomized control trial that will recruit 880 residents in ten residential care facilities (five of the ten are intervention facilities) and monitor outcomes over 6 months.
The model was developed after a 12-month pilot study at a residential care facility that identified rates of utilization of specialists by residents in long-term care and tested the feasibility of the telehealth service model. This provided a basis for the service model and potential for improvement integral to the current proposal.
If the telehealth approach is shown to be effective, it will not only indicate a mechanism to deliver better care, but also provide additional impetus for widespread implementation of telehealth as a vehicle to provide specialist care to residents in aged-care facilities.
|
|
Genetic Variant Associated with Risk of Alzheimer's Disease
The routine use of interRAI assessments in Icelandic nursing homes provided a unique opportunity for researchers who are seeking to identify links between genetic mutations and Alzheimer's disease. interRAI Fellow Palmi Jonsson is a member of a team that identified a link between a rare genetic mutation (called TREM 2) and the prevalence of Alzheimer's. This work was made possible by the routine availability of an embedded interRAI scale-the Cognitive Performance Scale or CPS-which can be calculated from all interRAI assessments. This work emphasizes the value of collecting robust information whenever assessments are performed. Such information has many subsequent uses, including high-grade research.
The work was published in a recent edition of the New England Journal of Medicine, which can be accessed at: http://imibe.gr/attachments/File/Variant2.pdf
|
|
interRAI Child and Youth Suite Momentum Is Building: An Update from Canada
We are excited to report that the development of interRAI assessments for children and youth is progressing extremely well. These assessments form a suite that will be the first to provide an integrated response to identifying and responding to child/youth mental health needs.
Pilot testing has started for five interRAI child and youth suite assessments. These share a focus on assessing mental health needs but are designed for specific populations or settings, including typically developing children and youth from 4 to 18 years, those with developmental disabilities, those with complex needs who receive services in the home and are between 0 and 18 years, adolescents, and a short screener that can be used to identify whether further, more comprehensive assessment of needs is required. These tools are being used by 206 service providers across twenty-five agencies within the province of Ontario, including inpatient/residential services and outpatient services delivered in the community as well as in schools.
As of February 2013, the assessments that focus on mental health needs for typically developing children and youth and their respective manuals will also be available in French. Continuing efforts also involve extensive collaboration to develop interRAI child/youth assessments for youth justice and education settings. The state of Arkansas is now implementing use of interRAI assessments as a foundation of an equitable, needs-based service system for children and youth with developmental disabilities.
The project recently received $100,000 from the London Community Foundation in Ontario, Canada, to further support the development and testing of the assessments designed for typically developing children and youth, as well as adolescents and those with developmental disabilities.
Watch for our upcoming child and youth research publications on the interRAI Web site. Several articles related to child/youth data collected using interRAI assessments will be posted shortly.
Click here if you want to learn more about the interRAI Child and Youth Mental Health/Developmental Disability suite of tools.
Click here if you want to learn more about the London Community Foundation.
Back to top
|
|
Forthcoming meetings
Don't Miss the 2013 Canadian interRAI Conference
On behalf of the Canadian interRAI Conference planning committee, we are pleased to invite you to submit a podium or poster presentation for consideration at the 2013 Canadian interRAI Conference.
The seventh Canadian interRAI Conference provides an important forum that brings together researchers, policymakers, and practitioners using the interRAI system of instruments in community and home care, residential/long-term care, acute care, assisted living, mental health care, and palliative care. These evidence-based electronic instruments capture client/patient assessment information that is used to support care planning and delivery, quality improvement, health system management, and policy development.
This year's conference is being held in Ottawa, Ontario, on October 7-10, 2013.
The committee encourages submissions from clinicians, researchers, educators, management, front line staff, and those responsible for policy development and planning who wish to share their knowledge, expertise, best practices, and strategies working with the interRAI system of instruments. This is an excellent opportunity to share expertise and best practices with colleagues from across Canada and abroad.
The submission deadline for the Call for Presentations is Friday March 22, 2013.
For the conference flyer, click here.
For more information on the Call for Presentations process and/or to submit a presentation for consideration, click here
Conference Web site: http://www.canadianinterrai.org/
Phone: 1-800-598-8002 x1357
Email: abstracts@canadianinterRAI.org
Back to top
|
|
Recent publications
Armstrong JJ, Zhu M, Hirdes JP, Stolee P. (2012). K-means cluster analysis of rehabilitation service users in the Home Health Care System of Ontario: examining the heterogeneity of a complex geriatric population. Arch Phys Med Rehabil. 93(12):2198-205. doi: 10.1016/j.apmr.2012.05.026. PubMed PMID: 22705468. [Epub ahead of print]
Costa AP, Poss JW, Peirce T, Hirdes JP. (2012). Acute care inpatients with long-term delayed-discharge: evidence from a Canadian health region. BMC Health Serv Res. 12:172. doi: 10.1186/1472-6963-12-172. PubMed PMID: 22726609; PubMed Central PMCID: PMC3424132.
Foebel AD, Hirdes JP, Heckman GA. (2012). Caregiver status affects medication adherence among older home care clients with heart failure. Aging Clin Exp Res. PubMed PMID: 22732397. [Epub ahead of print]
Hirdes JP, Freeman S, Smith TF, Stolee P. (2012). Predictors of caregiver distress among palliative home care clients in Ontario: evidence based on the interRAI Palliative Care. Palliat Support Care. 10(3):155-63. doi: 10.1017/S1478951511000824. [Epub ahead of print] PubMed PMID: 22436557.
Lakhan P, Jones M, Wilson A, Gray LC. (2012). The decline in activities of daily living at discharge (dadld) index: stratifying patients at lower and higher risk. Journal of Nutrition, Health & Ageing. 16(10):919-24.
Perlman CM, Hirdes JP, Barbaree H, Fries BE, McKillop I, Morris JN, Rabinowitz T. (2013). Development of mental health quality indicators (MHQIs) for inpatient psychiatry based on the interRAI mental health assessment. BMC Health Serv Res. 13(1):15. PubMed PMID: 23305286. [Epub ahead of print]
Back to top
|
|
|
|
|
