Abstract
The chronic diseases, comorbidities and rapidly changing needs of frail older persons increase the complexity of caregiving. A comprehensive, systematic and structured collection of data on the status of the frail older person is presumed to be essential in facilitating decision-making and thus improving the quality of care provided. However, the way in which an assessment is completed has a substantial impact on the quality and value of the results. This study examines the online completion of interRAI Home Care assessments, the possible causes for incomplete assessments and the consequences of these factors with respect to the quality of care received. Our findings indicate high nurse engagement and poor physician participation. We also observed the poor completion of items in predominantly medically- oriented sections characterized by, first, the fact that the assessors felt incapable of answering certain questions, second, the absence of required data or of a competent person to fill out the data, and third, the lack of tools necessary for essential measurements. The incompleteness of assessments has a clear negative influence on outcome generation. Moreover, without the added value of support outcomes, the improvement of care quality can be impeded and information technology can easily be seen as burdensome by the assessors. We have observed that multidisciplinary cooperation is an important prerequisite to establishing high-quality assessments aimed at improving the quality of care.
Highlights
Three decades ago, several studies identified significant and widespread poor quality of care related to the inability to identify the problems and needs of older persons [1, 2]
Possible causes can be found in the fact that first, the assessors felt incapable of answering certain questions, second, the absence of required data or a competent person, and third, the insufficient presence of tools necessary for carrying out essential measurements
When a comprehensive geriatric assessment (CGA) is completed in a coordinated and multidisciplinary way, whereby the items are filled out by all involved health professionals on the basis of their expertise or experience, we can assume that the assessment reflects the real situation of the client
Summary
Several studies identified significant and widespread poor quality of care related to the inability to identify the problems and needs of older persons [1, 2]. In 1983, Sidney Katz recognized the need for a uniform and comprehensive assessment in nursing homes [3]. All these observations were to lead to one of the cornerstones of modern geriatric care: the comprehensive geriatric assessment (CGA) [1]. PLOS ONE | DOI:10.1371/journal.pone.0123760 April 13, 2015
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