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The review and identification of an existing, validated, comprehensive assessment tool.

For older people with complex care needs and individuals with chronic health conditions a comprehensive assessment that is person centred and carer inclusive is integral to the successful management of an individual's care needs and the achievement of optimal health outcomes.

There is currently no standardised assessment tool used across service settings to comprehensively assess the care needs of these individuals. A common approach to assessment has the potential to improve service coordination, minimise the duplication of assessment and support a more integrated approach to client management.

The Continuing Care Unit, in conjunction with the Aged Care Branch and the Hospital Demand Management Group of the Department of Human Services, has recently supported a project to:

• Review existing comprehensive assessment tools for assessing people with chronic health conditions and older people with complex care needs and to identify a validated assessment tool for use in Victoria.
• Determine if the identified tool complements or duplicates the Personal Care Participation Assessment and Resource Tool (PC-PART) (formerly known as the Handicap Assessment and Resource Tool - HART), should the identified tool not be the PC-PART.

The project did not involve the development of a new comprehensive assessment tool.

The Lincoln Centre for Ageing and Community Care Research (Australian Institute for Primary Care, La Trobe University) successfully tendered to undertake this project. Key steps in the project included:

• The compilation of a list of attributes and domains that a comprehensive tool should encompass;
• Consultation with key stakeholders to examine current practice and inform the literature review to identify existing tools;
• The establishment of a technical panel to review the research evidence regarding the validity and reliability of each tool; and
• Workshops with key stakeholders to review the applicability and practicability of the tools under consideration.

In addition to the PC-PART, five tools identified as meeting the selection criteria for a comprehensive assessment tool were included in the review. They were: the Camberwell Assessment of Need for the Elderly (CANE); EASY-Care; FACE; Inter Resident Assessment Instrument (InterRAI) suite of tools; and the Outcomes and Assessment Information Set (OASIS).

Key findings

Workshop participants overall endorsed the need to move towards a more standardised approach to comprehensive assessment although opinions varied as to the utility of the tools under consideration. The technical panel concluded that the CANE, InterRAI, OASIS and EasyCARE currently have the strongest evidence of tool reliability and validity. However, in combination with the workshop participant's ratings of each tools applicability and practicability, the InterRAI rated the highest overall.

Irrespective of the tool adopted, workshop participants strongly supported the development of a framework that builds on the existing Better Access to Services Framework to guide the comprehensive assessment of older people with complex care needs and individuals with chronic health conditions.

In relation to the PC-PART, the Lincoln Centre for Ageing and Community Care Research concluded that this tool is not in itself a comprehensive assessment tool but could be used to complement other tools such as the InterRAI, EasyCARE or FACE tools.

A copy of the Lincoln Centre for Ageing and Community Care's final report can be accessed via the link on the right.

Next steps

A framework to guide the comprehensive assessment of older people with complex care needs and individuals with chronic health conditions will be developed in consultation with service users and providers. The framework will include a set of principles to support a client centred and carer inclusive approach to comprehensive assessment and establish clear processes for identifying clients who would benefit from a comprehensive assessment of their care needs.

An exploration of the costs associated with adopting the InterRAI suite of tools will be undertaken in early 2005 to inform future decision making regarding proceeding with a demonstration project. Costs to be considered include software to support the use of the InterRAI suite of tools in an electronic format and the costs of education and training to support the adoption of the tools.

A project undertaken by the Lincoln Centre for Ageing and Community Care Research, Australian Institute for Primary Care at La Trobe University for the Department of Human Services

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