Detect Health Risk in Vulnerable Populations with the Health Risk Screening Tool
Determine the Risk
The most important outcome of the HRST screening is to guide in the provision of health care support and surveillance. The instrument is used to determine the types of further assessment and evaluation required by the person to be safe and healthy in the least restrictive setting.
How it Works
This unique disability screening tool looks for health risks associated with a wide variety of disabilities, including developmental disabilities, physical disabilities, disabilities associated with aging and other conditions, all of which specifically affect systems of the body and the person’s ability to engage in functional activities and which many other health screening tools overlook.
Part of the instrument examines the health risks associated with psychiatric or behavioral disorders, particularly those that result from medications, self-injurious behavior or restriction of movement.
The HRST is a simple 22-item scale designed to find out who is at the greatest risk of illness and health destabilization. It then responds by producing action steps that empower support staff in the form of special attention and prevention.
Scores for 22 rating items are assigned by the user answering a series of objective Yes/No questions related to each item. The resulting numerical totals of the 22 rating items are assigned Health Care Levels associated with degrees of health risk.
Features & Functions:
- Detects health destabilization early in vulnerable populations.
- Field-tested, validated, reliable and user-friendly.
- Helps meet CMS health and safety requirements.
- Quantifies level of health risk based on objective criteria.
- Establishes a health baseline and allows the health status to be monitored.
- Assists with transition planning and continuity of care.
- Defines acuity.
- Identifies health related support needs specific to the person.
- Determines types of further assessment, evaluation and staff training.
- Enhances Individual Service Plan development.
- Enables personalized and less restrictive settings.
- Assists with budgeting and equitable resource allocation.
- Provides web-based, real-time data accessibility.
- Reports can display numerous parameters:
- And more
Three independent studies have been completed using the Health Risk Screening Tool and were conducted on people with intellectual and developmental disabilities
Journal of Nursing Measurement
“The HRST can predict mortality. Therefore, it can serve as a basis for establishing healthcare needs and determining nursing care acuity.“
Independent researchers with the Center for Outcome Analysis and the Georgia Department of Behavioral Health and Developmental Disabilities collaborated to study the ability of the HRST to predict mortality in people with IDD. The study highlights the efficacy of the HRST to predict mortality in a sample of 12,582 people with IDD. The researchers concluded that the “HRST’s Health Care Levels are predictive of mortality. Therefore, it can serve as a basis for establishing healthcare needs and determining nursing care acuity for people with IDD.”
A quote from the study
“All three methods of analysis employed in our study (Kaplan–Meier, Cox regression, and binary logistic regression) indicate that the six-point health risk score (i.e., Healthcare Level) produced by the HRST was prognostic of mortality in a sample of persons with intellectual disability. That is, the instrument is able to identify the degree of vulnerability in such a population.
Merrick and Morad (2011)(2) recommend that an HRA (Health Risk Assessment) become a standard component of the life plan of a person with an intellectual disability because it would allow for the detection of conditions that could compromise longevity, and our results suggest that the HRST can meet this need.”
Additional Studies Validating the HRST
The Center for Outcome Analysis (COA)
Predictive Validity of a Health Risk Screening Tool Designed for People with Developmental Disabilities, Michael J. Roszkowski, Ph.D., and James W. Conroy, Ph.D. Center for Outcome Analysis, 2016.
The study was conducted by Dr. James Conroy of the Center for Outcome Analysis and was done on a sample of over 16,000 people with IDD over a nine-year span and concluded that the HRST’s Health Care Level was prognostic of longevity.
Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)
A second study is presented by the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD). The Annual Mortality Report focuses on mortality, mortality trends, and related information pertaining to the health and care received by individuals with intellectual and developmental disabilities served by the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD). The report focuses on an analysis of mortality data and findings from DBHDD’s mortality review process. Reports have been scheduled for publication in August of each year since 2013 and cover the prior calendar year of January 1 through December 31.
The graph below depicts that with each one point increase in Health Care Level, there is a statistically significant increase in the rate of death.
Frequently asked questions
Studies have validated that the HRST Health Care Levels are predictive of mortality. In fact, a recent study out of the state of Georgia reveals that “similar to previous years, there was a statistical association between HCL and mortality rate in 2018.” In addition, “each one-unit increase in HCL was associated with an 59% increase in the odds of dying.1” Knowing each person’s HCL can empower action to prevent unnecessary deaths. Emphasis on HCL’s will be a major component of our service delivery to the client.
1 2018 Annual Mortality Report, Georgia Department of Behavioral Health and Developmental Disabilities, August 2019.