The interRAI HC (Home care) is primarily an assessment that guides care/service planning. When used on multiple occasions, it provides the basis for an outcome-based assessment of the person’s response to care or services. The interRAI HC has been designed to be compatible with the suite of interRAI assessment and problem identification tools. Such compatibility advances continuity of care through a “seamless” assessment system across multiple health care settings, and promotes a person-centered evaluation rather than fragmented site-specific assessments.

interRAI

The home care instrument has been adopted nationally in 2 countries and mandated regionally in 12 countries.

The interRAI HC can be used to assess persons with chronic needs for care, as well as with post-acute care needs (e.g., after hospitalization or in a hospital at home situation).

The interRAI HC is designed for use by clinical professionals (e.g., nurses, social workers, physicians, therapists, etc.). Purposes include service planning, outcome assessment, quality monitoring and resource utilitization.

The interRAI HC has been designed to be a user-friendly, reliable person-centered assessment system that informs and guides comprehensive care and service planning in community-based settings around the world.

The interRAI HC consists of the interRAI HC Assessment and the Clinical Assessment Protocols (CAPs):

The interRAI HC Assessment Form is a Minimum Data Set (MDS) screening tool that enables a home care provider to assess multiple key domains of function, health, social support, and service use. Particular interRAI HC items also identify persons who can benefit from further evaluation of specific problems or risks for functional decline. These items, known as “triggers”, link the interRAI HC to a series of problem-oriented CAPs.

The Clinical Assessment Protocols (CAPs) contain general guidelines for further assessment and individualized care and services. There are 30 CAPs in multiple domains (e.g., clinical, mental health, psychosocial, physical function). On average, a person receiving home care services triggers about 10 of the 30 CAPs.

Reliability of individuals items has been tested multiple times in multiple countries. Vast majority of items have kappa of 0.6 or higher. Many key items eg ADL and cognitive items have kappas of 0.8 or higher.

The interRAI HC focuses on the person’s functioning and quality of life by assessing needs, strengths, and preferences. The interRAI HC Assessment Form is a Minimum Data Set (MDS) screening tool that enables a home care provider to assess multiple key domains of function, health, social support, and service use. Particular interRAI HC items also identify persons who can benefit from further evaluation of specific problems or risks for functional decline.

The assessment process requires communication with the person and primary caregiver/family member (if available), observation of the person in the home environment, and review of secondary documents when available. Where possible, the person is the primary source of information.

There are subscales in specific areas that can be summed and used as outcome measures or predictive scales eg ADL, CPS, DRS, Chess. In addition, individual items or combinations known as “triggers”, link the interRAI HC to a series of problem-oriented CAPs. The Clinical Assessment Protocols (CAPs) contain general guidelines for further assessment and individualized care and services. There are 30 CAPs in multiple domains (e.g., clinical, mental health, psychosocial, physical function). On average, a person receiving home care services triggers about 10 of the 30 CAPs.

Is the instrument being used outside the original target population?

A multinational group of clinicians and researchers, consisting of interRAI Fellows, began work on Version 1 of the RAI HC in 1993. Several different drafts of Version 1 were released between 1994 and 1997 – including Version 1.7, Version 1.10a, and Version 1.11. These instruments were used extensively in North America, Europe, and Asia.

In 2006, interRAI suite instruments were published following extensive reliability testing internationally.

Is the instrument in the public domain (Y/N)?

Kwan CW, Chi I, Lam TP, Lam KF, Chou KL. (2000) Validation of the Minimum Data Set for Home Care Assessment Instrument for Hong Kong Chinese Elders. Clinical Gerontology 21(14):35-48.

Landi F, Tua E, Onder G, Carrara B, Sgardari A, Rinaldi C, Gambassi G, Lattanzio F, Bernabei R; SILVERNET-HC Study Group of Bergamo. Minimum Data Set For Home Care: A Valid Instrument To Assess Frail Older People Living In The Community. Medical Care 38(12): 1184-1190.

Morris, Fries, Steel, Ikegami, Bernabei, Carpenter, Gilgen, Hirdes, Topinkova. (1997) Comprehensive Clinical Assessment in Community Setting: Applicability of the MDS-HC. Journal of the American Geriatrics Society 45(8):1017-1024.

Morris JN, Fries B, Bernabei R, Steel K, Ikegami N, Carpenter I, Gilgen R, DuPasquier JN, Frijters D, Henrard JC, Hirdes J, Belleville-Taylor P, Berg K, Björkgren M, Gray L, Hawes C, Ljunggren G, Nonemaker S, Phillips C, Zimmerman D. User’s Guide for the interRAI HC, Washington, DC: interRAI, 2006.

interRAI CHA (community health assessment) is a subset of the home care instrument.