The power of the MDS, and the will to rein it in
James M. Berklan
The Minimum Data Set helps determine how resident care is classified and reimbursed. Because it drives providers' fate, virtually from start to finish, operators cling to any nugget they can glean about it. That's why newly released study findings prove so intriguing.
As reported by McKnight's Tim Mullaney in Tuesday's Daily Update, long-term care staffers' understanding of the MDS and its Quality Indicators is considered, well, less than optimal. This unfavorable assessment comes from their supervisors themselves.
That certified nursing aides do not feel in the loop about the expansive assessment tool is not surprising. By job definition, they are often excluded from much of the MDS process. To the extent their managers would like to see them more involved, however, is heartening.
Survey respondents identified six key ways that providers could enhance their staff members' understanding of the 16 MDS Quality Indicators. They begin with education/training (35% of respondents), which would include structured and/or in-service programs. Next, they suggest increased involvement (19%), meaning more engagement in computation, review and interpretation of the QIs.
Ongoing informal training and reminders (18%), meaningful application (13%) and simplification of the MDS and/or QIs (6%) were the next most frequently recommended.
With the observations and responses coming from a group made up mostly of nurse and assessment veterans, it seems that change for the good should be within reach. Survey respondents were mostly managers or long-timers who should be able to have some sway in how staffers are educated and included in MDS and QI affairs. It will be interesting to see if top managers, and their superiors, will take the medicine they called for.
The researchers recommend, naturally, that more research be conducted. It's worth finding out if these results — which were derived from Veterans Administration employees using MDS 2.0 — would be replicated in for-profit and nonprofit facilities of varying sizes.
Power on, I say. This stuff is too compelling to ignore or treat with indifference. Knowledge is power. In this case, it also might improve resident health and care.
James M. Berklan is McKnight's Editor. Follow him @LTCEditorsDesk.