全球智库信息集成服务系统

Identification of candidate SPADEs

• Candidate SPADEs to assess cognitive status included the Brief Interview for Mental Status, Confusion Assessment Method, and Staff Assessment of Mental Status.
• Candidate SPADEs to address pain included a pain interview and staff assessment of pain or distress.
• Candidate SPADES to address impairments included assessments for hearing and vision and bladder and bowel incontinence.
• Candidate SPADES to address use of certain special services, treatments, and interventions focused on nutritional interventions, as well as others — for example, chemotherapy, radiation, and oxygen therapy.
• Other candidate SPADEs assessed care preferences, medication reconciliation, and health-related quality of life.

Data collection and sample

• Data were collected from a wide range of environments, allowing for thorough evaluation of candidate instruments in all PAC settings.
• 143 PAC facilities/agencies in 14 markets across the country contributed patient/resident assessment data to the National Beta Test.
• The test design called for assessment data to be collected at both admission and discharge by trained research nurses, as well as by trained facility/agency staff from each participating provider.

Data analysis

• There were four primary goals for the data analysis: (1) to compute descriptive statistics for candidate SPADEs, (2) to determine the feasibility of administration, and (3) to evaluate interrater reliability between pairs of research nurses and facility/agency staff assessors, and (4) to determine the content validity of candidate SPADEs.
• Secondary goals were also established. For example, some analyses examined differences in SPADE performance according to look-back period or assessment days.

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 2 of the final report on the National Beta Test. It focuses on the design and methods for the National Beta Test. This volume covers the candidate SPADEs tested; the design and sampling plan; information on training, recruitment, and retention; information on the data collection process and analytic plan.

• Chapter One

  Introduction

• Chapter Two

  Candidate SPADEs Included in National Beta Testing

• Chapter Three

  Design and Sampling

• Chapter Four

  Provider and Research Nurse Recruitment

• Chapter Five

  Training

• Chapter Six

  Data Collection

• Chapter Seven

  Analytic Plan

• Chapter Eight

  8888

• Appendix A

  Past Performance, Current Use, and Input Opportunities for Candidate SPADEs Tested in the National Beta Test

• Appendix B

  National Beta Test Research Nurse Training Agenda

• Appendix C

  Example National Beta Test Field Training Agenda (Boston)

• Appendix D

  National Beta Test Field Staff Web-Based Survey Questions