1. Seminar on MDS 3.0 Arif Nazir MD CMD 8/12/10 Barriers to MDS Use

2. Minimum Data Set The 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

3. 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.

4. 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”

5. I am a: Physician that sees nursing home patients Medical Director (Internal Medicine) Medical Director (Family Practice) Medical Director (Other specialty) Nurse practitioner/ Physician assistant Nursing staff in a nursing home Nursing home MDS coordinator Other

6. Familiarity 1.I am NOT familiar with the MDS 2.I am somewhat familiar with the MDS 3.I am familiar with the MDS 4.I am an EXPERT on MDS

7. 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

8. MDS Care Plans 1.I never review the care plans 2.I review the care plans infrequently 3.I review the care plans frequently 4.I always review the care plans 5.Not applicable

9. The MDS section I find the most helpful in patient care: A. Cognition B. Functional assessment C. Mood and Behavioral disorders D. Skin condition E. Communication/Hearin g patterns F. Other G. Not applicable

10. My main CONCERN is that MDS is: A. Tedious B. Inaccurate C. Irrelevant D. Complex E. Vague

11. My Main BARRIER to Use of MDS A.Lack of training and education about MDS B.Irrelevant to my patients C. Time constraints D. Other (Please write the reason in provided space)

12. 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

13. 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