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• In terms of feasibility, missing data were very low for all three tested data element sets, but there was some variability in time to complete. The Global Health data elements, which include ten questions, took the longest to complete. The Care Preferences interview and chart review data elements were completed more quickly.
• Responses to these data elements tended to be similar from admission to discharge, with the exception of PROMIS Global Health. Although there was a moderate degree of stability from admission to discharge for PROMIS Global Health, patients/residents at discharge were more likely to show improvement in symptoms than to worsen (compared with admission).
• As with the quantitative results, assessor feedback is generally supportive of these data elements. This was particularly true for clinical utility, in that all data elements were deemed at least moderately clinically useful and, for Care Preferences and Medication Reconciliation, especially important for patient transfers.

The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to evaluate candidate standardized patient assessment data elements (SPADEs) in a national field test titled the National Beta Test. The National Beta Test was conducted to evaluate the performance of candidate SPADEs in the clinical categories of (1) cognitive function and mental status; (2) special services, treatments, and interventions; (3) medical conditions and comorbidities; (4) impairments; and (5) other categories, for use in four post-acute care (PAC) settings: home health agencies, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities.

This is Volume 7 of the final report on the National Beta Test, which includes the identification and testing of candidate SPADEs that fall into other clinical categories (care preferences, medication reconciliation, and global health). This volume provides results and significance tests on the feasibility, reliability, validity, stability and change over time, and sensitivity to national representativeness of the candidate SPADEs. The data elements tested include PROMIS Global Health, Care Preferences, and Medication Reconciliation. All three data element sets performed fairly well, with some variability in performance.

• Chapter One

  Introduction

• Chapter Two

  Standardized Assessment of Global Health, Care Preferences, and Medication Reconciliation in Post-Acute Care

• Chapter Three

  PROMIS Global Health

• Chapter Four

  Care Preferences

• Chapter Five

  Medication Reconciliation

• Chapter Six

  Conclusion

• Appendix

  Supplementary Tables