RAI-MDS 2.0 Nutritional Care Resource Guide April 2011 - CCIM

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RAI-MDS 2.0 Overview for Nutrition TeamWHY IMPLEMENT RAI-MDS 2.0 IN ONTARIO’S LTC HOMES? RAI-MDS 2.0 provides better assessment and care planning Good assessment is the foundation for a comprehensive nutrition care planRAI-MDS 2.0: RESIDENT BENEFITS RAI-MDS 2.0 provides a holistic interdisciplinary assessment of resident care needs and the development ofan individualized plan of care that reflects resident’s strengths, preferences and goals Identifies actual and potential resident care needs, concerns and risks in a timely fashion Encourages resident and family involvement Respects the value of helping residents achieve their highest level of functioning and quality of lifeRAI-MDS 2.0: CARE TEAM BENEFITS Strengthens interdisciplinary care delivery process by:- Identifying residents’ needs and interventions more effectively- Determining the root causes of needs and concerns- Helping to plan and implement individualized care- Providing clear and comprehensive information for evidence-based clinical decision making Monitors quality by:- Tracking resident-specific outcomes- Monitoring resident change over time Promotes researchRAI-MDS 2.0: MANAGER BENEFITS Provides comprehensive and timely information and reports for quality improvement, performanceassessment, benchmarking and accreditation Compares, measures and tracks health outcomes (over time / across sites of care) Supports clinical best practice, strategic planning, program evaluation, quality improvement activities,resource allocation as well as clinical and operational reviewsRAI-MDS 2.0: MINISTRY BENEFITS Provides comparable data locally, regionally and nationally to support resource needs evaluation andallocation Delivers effective ways to measure quality Enhances availability of quality and comprehensive data for province-wide benchmarking, policydevelopment and system planningRAI-MDS 2.0 INSTRUMENT Is a reliable, validated and interdisciplinary assessment tool Completed on admission, quarterly, annually and upon a significant change in status Identifies the majority of a resident’s strengths, needs and preferences Captures residents care needs over 24 hours Includes a full and a quarterly assessment tool- Full assessment tool contains 20 sections and over 450 items- Quarterly assessment tool contains 18 sections and over 300 itemsFor Information: 416.327.7625 3ltchrai@ontario.ca3
RAI-MDS 2.0 Target population:Frail elderly and disabled adults in long-term care settingsRAI-MDS 2.0 was developed by: The Health Care Financing Commission (now CMS) The Research Triangle (Hebrew Rehabilitation Centre for the Aged in Boston, The University of Michiganand Brown University) Expert health care consultants and Advisory panels: nurses, doctors, physiotherapists, occupationaltherapists, speech therapists, activities therapies and nutritionists Others: consumers, resident advocates, nursing home industry representatives, regulators andmeasurement specialistsinter-RAI Suite of Instruments (www.interrai.org):Acute CareAssisted LivingCommunity Mental HealthHome CareIntellectual DisabilitiesLong-Term Care FacilitiesMental HealthPost Acute CarePalliative CarePersons with DisabilitiesinterRAI ScreenerCIHI RAI-MDS 2.0 USER’S MANUAL (UPDATED SEPTEMBER 2010) Helps with coding and is critical for maintaining and enhancing data quality Addresses each coding item with:o Intento Definitiono Processo Coding choiceso Offers helpful exampleso Includes CIHI tips* Contact www.cihi.ca to obtain the new version of the RAI-MDS 2.0 User’s Manual (September 2010).For Information: 416.327.7625 4ltchrai@ontario.ca4
Page 1 and 2: RAI-MDS 2.0 Nutritional Care Resour
Page 3 and 4: Table of Contents1. Chapter 1: RAI-
Page 5: Glossary of TermsADLAlgorithmAverag
Page 9 and 10: SECTION F: PSYCHOSOCIAL WELL-BEINGI
Page 11 and 12: SECTION P: SPECIAL TREATMENTS AND P
Page 13 and 14: SECTION V - RESIDENT ASSESSMENT PRO
Page 15 and 16: OUTCOME SCALES OR MEASURES• 10 ou
Page 17 and 18: Getting Started ChecklistCompletion
Page 19 and 20: Selected Coding Sections of RAI-MDS
Page 21 and 22: WEIGHT CHANGE CALCULATION EXAMPLE:C
Page 23 and 24: EXAMPLE:Step 1: Calculate Total Cal
Page 25 and 26: Examples include wheat-free diet to
Page 27 and 28: Overview of Assessment TimelinesOBS
Page 29 and 30: 2. QUARTERLY ASSESSMENT TIMELINEThe
Page 31 and 32: TIMELINE FOR SIGNIFICANT CHANGE IN
Page 33 and 34: RAI-MDS 2.0 Nutrition Assessment Pr
Page 35 and 36: Day 0 First Day of New Admission On
Page 37 and 38: RAI-MDS 2.0 Nutrition Quarterly, Si
Page 39 and 40: Preparing to Code ChecklistThe foll
Page 41 and 42: Recommended Tools (Optional)Admissi
Page 43 and 44: Sensory Deficit Affecting Nutrition
Page 45 and 46: Admission Nutrition Assessment Work
Page 47 and 48: Essential Nutritional Assessment Ar
Page 49 and 50: Nutrition/Hydration Risk Identifica
Page 51 and 52: Assessing Nutrition / Hydration Ris
Page 53 and 54: CHAPTER 3: Resident Assessment Prot
Page 55 and 56: TRIGGERED RAPS IN THE RAI-MDS 2.0 R
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TRIGGERED RAP OR NON-TRIGGERED CLIN
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What have you read to support evide
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NO EXISTING RAP TRIGGEREDIf existin
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RAP IMPLEMENTATION STRATEGIES Compl
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NEW ADMISSION RAP AND CARE PLAN TIM
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M axim um 7 days M aximum 7 days Ma
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RAPS and Care Planning Software Ori
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The College of Dietitians of Ontari
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8 Documentation by the dietitian in
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17.10 Draws relevant conclusions fr
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RAPProcessLeaves25% ormore foodunea
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RAP Process Step 1Type of RAPLeaves
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Dietitian ReferralDietitian Referra
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13. Dental Care14. Pressure UlcersD
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New triggered RAPs affecting nutrit
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Criteria to Review4. Evidence of RA
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OverviewOVERVIEW• Getting started
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MoodWorsened mood - symptoms of dep
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15. Prevalence of depression withou
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• E1l - Sad, pained worried facia
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AGGRESSIVE BEHAVIOUR SCALE (ABS)•
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• Hemiplegia, pneumonia, septicem
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Preparing for RAI-MDS 2.0 Outputs a
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Application of RAI-MDS 2.0 Reports
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Case Study ApplicationThe Quality I
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Domain # Quality Indicators - Unit
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Domain # Quality Indicators - Unit
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4-35Domain # Quality Indicators - U
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InterRAI RAI-MDS 2.0 Quality Indica
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For Information: 416.327.7625 28ltc
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Strategies for Achieving RAI-MDS 2.
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RAI-MDS 2.0 Quality Improvement Too
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Comments:Part C: Use of Data for De
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Literature: Recommended Articles1.
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RAI-MDS 2.0 Nutritional Care Resource Guide April 2011 - CCIM

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