Seminar on MDS 3.0

Arif Nazir MD CMD8/12/10

Barriers to MDS Use

Minimum Data SetThe Minimum Data Set (MDS), a federally mandated comprehensive resident assessment tool serving multiple purposes :• Resident Assessment Protocols (RAPs) driven care planning• Assessing Medicare reimbursement rates• Promoting quality monitoring and improvement• To achieve the multifaceted objectives there were some tradeoffs

MDS and Provider Attitudes• More than 25% never reviewed the MDS information 40% never used this information.• Majority (56%) of expressed attitudes toward the MDS were negative.• Common complaints included inaccuracy, time involved in completion and review, and redundancy.• Physicians with a higher NH caseload used the MDS less than did those with fewer patients in NHs

Jogerst G, Daly J, Zimmerman MB. Physician use of and attitudes regarding the Minimum Data Set. J Am Med Dir Assoc 2001;2:4 –9.

Objectives of our Discussion*

1. A set of diverse solutions to 1. improve providers’ utilization of

the MDS information

2. making MDS more provider-friendly

*Avoid negative criticism (we already recognize that providers have failed to consistently use MDS as a tool in care provision and exhibit negative attitudes towards this tool)- “Let us not beat a dead horse”

I am a:Physician that sees nursing home patientsMedical Director (Internal Medicine)Medical Director (Family Practice)Medical Director (Other specialty)Nurse practitioner/ Physician assistantNursing staff in a nursing homeNursing home MDS coordinatorOther

Familiarity

1. I am NOT familiar with the MDS2. I am somewhat familiar with the MDS3. I am familiar with the MDS4. I am an EXPERT on MDS

Review

1. I never review the MDS information

2. I review the MDS information infrequently

3. I review the MDS information frequently

4. I always review the MDS information

5. Not applicable

MDS Care Plans1. I never review

the care plans2. I review the

care plans infrequently

3. I review the care plans frequently

4. I always review the care plans

5. Not applicable

The MDS section I find the most helpful in patient care:

A. CognitionB. Functional

assessmentC. Mood and

Behavioral disordersD. Skin conditionE. Communication/

Hearing patternsF. OtherG. Not applicable

My main CONCERN is that MDS is:

A. TediousB. InaccurateC. IrrelevantD. ComplexE. Vague

My Main BARRIER to Use of MDS

A. Lack of training and education about MDS

B. Irrelevant to my patients

C. Time constraintsD. Other (Please write

the reason in provided space)

Most important strategy to increase my use of MDS and care plans in patient care will be:

A. Education/ training tailored to my needs

B. Facility systems: to ensure my involvement in MDS reviews and care planning

C. MDS tool that provides summary of important clinical domains

D. Other (Please write in the provided space)

E. Not applicable

Education

1. I have never had MDS training before

2. I have had one MDS education/training session before

3. I have had multiple MDS education/training sessions