Teething issues with interRAI pilots did not put off more than 80 facilities lining up to be early adopters in the $11 million national roll-out of the international resident assessment system.

Fiona Cassie reports.

Registered nurses from about 40 facilities will be first off the block this month in starting training for using interRAI to assess their residents.

The national, multidisciplinary steering group announced in early October the successful 40 facilities from about 80 applicants seeking to be early adopters in the four-year national roll-out.

In late August the government confirmed $11 million funding towards covering the cost of introducing the interRAI clinical assessment tool including education and training, software licences and some hardware such as laptops.

Minister of Health Tony Ryall said at the time that the internationally proven clinical assessment system would help nurses better identify and monitor the needs of individual patients.

The standardised data also could be used to identify national trends, allowing the sector and public health service to take a more “proactive approach” to resident care, Ryall said. The sector also hopes that this hard data may influence resthome funding.

Steering group member and New Zealand Aged Care Association (NZACA) chief executive Martin Taylor said they would have liked at least 40 facilities to be under way this year: “We were spoilt for choice, as there were about 81 individual facilities that wanted to be early adopters,” Taylor said.

But initial numbers were limited by how many lead practitioners could be trained in the lead-up to Christmas.

The selection process principles were to try and ensure the early adopter group included a good spread of resthome, hospital and dementia facilities, a fair representation of both the for-profit sector and the religious and welfare sector, a reasonable geographic distribution, and a good representation of small, medium and large facilities.

The residential care tool had a demonstration trial in 2008 in Auckland and Tauranga using gerontology nurse specialists or NASC assessors, and in the same year a pilot, involving initially 25 registered nurses in 18 facilities, got started in Canterbury.

INsite spoke to a number of nurses on the Canterbury pilot who gave the clinical side of the assessment a thumbs-up but expressed doubts about the user-friendliness of the process. Only some had access to laptops for the pilot.

Gerontology nurse practitioner Michal Boyd was lead researcher for the northern demonstration trial that used tablet laptops and different software than the Canterbury pilot. She is a supporter of interRAI as an information tool but continues to believe its success will depend on having the right technology and systems available to support nurses. Particularly in the usually low-tech environment of residential aged-care.

Boyd said introducing interRAI into the residential sector is “very do-able” with good technology support including compatibility with existing IT systems. “The issue will be usability at the coal face,” she said.

Taylor said the rollout would provide laptops or tablets for individual facilities if they required them. He said in the early stages this was likely to be laptops but the extra hardware provided would be decided on a case-by-case basis with each facility to ensure it met their IT requirements.

Taylor said the same software provider as for the Christchurch pilot, Momentum, was to be used, following a public tender process and, initially at least, the same software version, as this was known to be robust and stable. He said issues raised in the pilot, particularly with print-outs and presentation aspects had been fed back to Momentum and would be addressed by the next version.

The three-day training progammes for registered nurses chosen to be their facility’s lead practitioner are due to start later in October; interRAI assessments will begin soon after.

A meeting is to be held in November of interRAI New Zealand, the governance body made up of Ministry of Health, DHB, academic, provider and consumer representatives, to discuss the data to be collected by interRAI and how it will be used, including benchmarking facilities.

The roll-out to the residential care sector of the interRAI LTCF (long-term care facility) tool follows the earlier roll-out of the compatible interRAI HC (home care) assessment tools for people in the community.

A network of researchers from over 30 countries make up the interRAI collaborative. The aim is to promote evidence-based clinical practice and policy to improve healthcare for older people, the frail or disabled. The collaborative has developed a range of assessment instruments or tools using a common language, to assess the health and needs of people in community care or residential care. It uses standardised data collection so statistical trends can be gathered on a facility-by-facility, regional or national level.