Who should complete interRAI assessments in your organization?
Selecting the right assessor depends on the type of organization.
In long-term care, most interRAI assessments are completed by nurses and sometimes by occupational therapists, physiotherapists and/or social workers. Some organizations have super users whose sole responsibility is to conduct interRAI assessments, while other sites have an interdisciplinary team complete their assessments.
In home care, the assessor is usually a case manager or care coordinator. These people are typically nurses by background, but assessors can also be occupational therapists, physiotherapists or social workers.
In community health, the person completing the interRAI assessment may not have a clinical background. (See What skills do interRAI assessors need? below.)
In the mental health environment, the assessor is usually someone with knowledge about and skills, abilities and experience in conducting a mental health assessment, as well as knowledge about best practices in mental health. This is usually a clinician (nurse, social worker, occupational therapist, physician or psychologist).
Multidisciplinary responsibility means that nurses complete specific sections and other allied health professionals (occupational therapists, physiotherapists or social workers) may complete others. This approach recognizes the inherent expertise that each team member brings to the assessment. With this approach, 1 person usually takes the lead and assumes overall responsibility for making sure the assessment is completed on time.
- Ability to establish a therapeutic relationship, and strong communication skills to work with clients
- Strong interpersonal skills to communicate and collaborate with the interdisciplinary team
- Technical skills/computer skills to complete the assessment using the organization’s software
- Receptiveness to change and willingness to take part in the change process (attending training, influencing others, supporting other members the health care team, supporting initiatives) — these may be informal leaders and/or the individuals you see as champions
What titles do interRAI assessors usually go by?
In general, there isn’t a consistent title because there isn’t a consistent type of individual or discipline assuming the role. Titles can also depend on the sector. Examples include
- RAI coordinator
- RAI assessor
- MDS coordinator
- Clinical resource nurse
- Clinical/care coordinator
- Case manager
- Health information professional
- Informatics specialist
- Applications specialist
- Clinical support/decision support analyst
- Nurse educator
- Inpatient/decision support manager
- GEM nurse, activation nurse
Do RAI coordinators in facilities usually just complete interRAI assessments, or do they have other clinical work as well?
This depends on the type and size of the organization. In some facilities, coordinators are dedicated purely to completing assessments, while in others the inter RAI coordinators have additional responsibilities, such as clerical tasks, data submissions, workload assignments or clinical responsibilities.
How should an organization handle backfilling when the primary assessor is away? Do you need to train several people? And how should you handle scheduling?
Again, this depends on the organization. Some train their entire staff (usually nurses) to complete interRAI assessments, and each staff member is then responsible for his or her own workload assignment. Some organizations train 1 person who completes all the assessments monthly or quarterly. Organizations may or may not have back-up assessors.
In long-term care, there are usually several assessors on staff. However, some organizations may not have any back-up assessors. Too often, assessments are not completed when the primary assessor is absent. In this case, clinicians continue to do their documentation and the assessor fills out the assessment retroactively based on the Assessment Reference Date (ARD).
Scheduling for assessments is handled by the RAI coordinator based on the ARD, which is driven by the software.
In home care, there is usually no back-up person assigned to complete the regularly scheduled assessment. However, if there is a significant change in a client’s status and the assessor will be absent beyond the 14 days available in which to complete the assessment, a back-up person would complete the significant change assessment.
To be successful, your organization should look at interRAI processes as being role dependent instead of person dependent, with a fundamental expectation that whoever is working in a particular role on a given day owns the interRAI responsibilities for that role.