interRAI Preliminary Screener for Primary
Care and Community Care Settings
(interRAI Preliminary Screener) Training
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Agenda
Welcome and Introductions
Part 1: CSS CAP Overview
Part 2: Preliminary Screener Assessment Training
• Screener Assessment Overview
• Objectives
• Coding the Preliminary Screener
Part 3: Assessment and Communication Skills
Part 4: Putting it all together: Role Play and Coding
• Wrap-up and Evaluation
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Classification: Medium
Workshop Documents
Review binder
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Part 1:
CSS CAP Overview
4
CSS CAP High Level Assessment
Process
Client
SCREENER/
INTAKE
ASSESSMENT
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COMPREHENSIVE
ASSESSMENT
(HC/CHA)
CARE PLAN
SERVICE PLAN
PROVIDE SERVICE
AND/OR REFER AS
APPROPRIATE
CSS Assessment Type by Client and
Program
interRAI CHA
Clients requiring
comprehensive
assessment to inform
care planning – significant
ADL/IADL support
interRAI CHA
or Screener
Clients have ADL/IADL
needs, caregiver
involvement
Need for CHA may be
informed by caregiver’s
ability to manage
Screener
Clients requiring
single service for low
intensity support
Independent in
managing ADL/IADL
Assessment recipient
HSPs/Programs that may support care plan –
client has complete assessment
Types of Program
Adult Day Services, Personal
Support /Independence
Training, Assisted
Living/Supportive Housing
(SDL), Attendant Outreach,
Case Management/ Care
Coordination
Caregiver Support, Crisis
Intervention, Overnight
Care, Respite
Meals on Wheels, Friendly
Visiting, Transportation,
Homemaking
Deaf, Deafened and Hard of
Hearing Care Services, CNIB
PRC, Aphasia,
Home Maintenance,
Congregate Dining,
Foot Care
What is the interRAI CHA?
interRAI Community Health Assessment (CHA) helps
identify adults needing supports to prevent or stabilize early
functional or health decline
•
•
•
•
A standardized comprehensive assessment
Modular format
Not all inclusive – “minimum” data set
Data elements designed to be used for:
– Care planning
– Quality improvement using quality indicators
– Outcome measures based on clinical scales
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Core interRAI CHA domains: A-P
*Identification Information
Intake and Initial History
*Cognition
Communication and Vision
*Mood
Psychosocial Well-being
*Functional Status
Continence
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Disease Diagnoses
*Health Conditions
Nutritional Status
Medications
Treatments and Procedures
Social Relationships
Environmental Assessment
Discharge
Functional Supplement Domains
Identification Information
Cognition
Mood and Behaviour
Functional Status
Continence
Disease Diagnosis
Health Conditions
Oral and Nutritional Status
Adapted with permission from ideas for health,
University of Waterloo, June 2010
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Skin Condition
Medications
Treatments and Procedures
Responsibility
*Social Relationships
Environmental Assessment
Discharge Potential
Part 2:
Preliminary Screener
Assessment Training
Format
• Interactive, with time for questions/clarification
• Participants are encouraged to:
– reflect on their current intake experiences as it
relates to assessment
– explore how the Preliminary Screener impacts their
current business practices
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Classification: Medium
Objectives
Following this section Preliminary Screener Assessors will
have increased knowledge in the following areas:
• Benefits of the Preliminary Screener
• Role of the assessor in the Preliminary Screener
process
• How to complete the Preliminary Screener
• How the screener fits into the overall client assessment
process
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Classification: Medium
interRAI Preliminary Screener Overview
interRAI Preliminary Screener will support the
intake process guided by the following two main
goals:
• Enable decision-making related to identifying
persons who would likely benefit from a
comprehensive assessment
• Record basic information about persons who
would not be receiving a comprehensive
assessment at a later stage
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Benefits of the interRAI Preliminary
Screener
• Can be completed over the telephone
• Collects essential information needed at time
of intake or screening
• Informs and supports decisions regarding need
for a comprehensive assessment or not
• Facilitates inter-agency communication through
common assessment language
• Standardized, aggregate data can inform
evidence-based decision making and planning
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Classification: Medium
What is the interRAI Preliminary
Screener?
The interRAI Preliminary Screener:
• Is a rudimentary screener to filter out persons least likely
to benefit from undergoing a basic assessment
• Is NOT a comprehensive assessment
• Only includes the minimum number of assessment items
needed to stratify clients into one of two groups:
•
•
•
•
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Those persons who are likely to benefit form a more detailed
assessment and,
Those who would not benefit from a more detailed
assessment
Should not be used for service planning
Short, simple and quick to complete
Classification: Medium
interRAI Preliminary Screener: Structure
The interRAI Preliminary Screener is designed to be
used as a multi-step process involving documentation
and decision-making in the following sections:
1. Identifiers/Demographics
2. Preliminary Screener – (7 domains)
Cognitive skills, 4 ADLs, dyspnea, self-rated health,
unstable condition, self-reported mood, informal
helper status
3.Summary
• Assessment urgency
• Decision re: need for further assessment/interRAI
CHA
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Classification: Medium
Completing the interRAI Preliminary
Screener
Section A: Identification Information
Intent - to obtain personal identifiers
necessary to identify the person and link
sequential assessments in an electronic
database.
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Classification: Medium
Completing the interRAI Preliminary
Screener
Section B: Screener Questions
Contains items used for a
decision-making algorithm to
differentiate persons who do
not require further screening
or assessment from those
who are likely to benefit from
further evaluation.
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1. Cognitive skills for daily
decision making
2. Activities of daily living
3. Dyspnea
4. Self-reported health
5. Instability of conditions
6. Self-reported mood
7. Informal helper status
Classification: Medium
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Assessment Urgency Algorithm v2
interRAI Preliminary Screener for Primary Care and Community Care Settings© v1
Self –reliance Index
Person is IMPAIRED if ANY of the following characteristics are present:
 Modified independent or any impairment in Cognitive Skills for Daily Decision Making (B1 = 1)
 Received supervision or any physical help in the assessed ADLs:
o Bathing (B2a = 1)
o Personal hygiene (B2b = 1)
o Dressing lower body (B2c = 1)
o Locomotion (B2d = 1)
Self-reliant
Impaired
Family Overwhelmed
(B7b= 1)
Self –rated Health: Excellent or Good
(B4 = 0 or 1)
No
Dyspnea OR Unstable
Condition
(B3 = 1, 2, or 3 OR B5a=1)
No
Yes
No
3
1
Yes
No
3
4
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Yes
Support in Personal
Hygiene ADL
(B2b = 1)
No
ideas for health October 15, 2010
Yes
Self –rated Mood: Sad,
Depressed, Hopeless
(B6= 1)
Unstable Condition
(B5a=1)
Yes
2
No
Yes
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6
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Completing the interRAI Preliminary
Screener
Section C: Summary
Intent: to record the computer-generated
algorithm score (that is embedded in the
interRAI Preliminary Screener) so that it
may be used to inform decisions related to
assessment urgency.
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Classification: Medium
Q&A / Evaluations
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Classification: Medium
Thank you!
Project Support Centre
Contact Information
Email:
csscap@ccim.on.ca
Toll Free: 1-866-909-5600
Website: www.ccim.on.ca
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