Using Routinely Collected Clinical Assessments in Mental Health Services: The Resident Assessment Instrument–Mental Health

Dr Urbanoski and colleagues1 examined the use of the Resident Assessment Instrument–Mental Health (RAI-MH) for specialized inpatient mental health services. While the article underscores the importance of a comprehensive approach to implementation (for example, training or information technology infrastructure), much of the critique appears to reflect a lack of understanding of the design and applications of the RAI-MH. Urbanoski et al imply that the RAI-MH system was developed outside of real-world contexts when, in fact, front-line clinicians were engaged in all aspects of the development and refinement of the instrument and its applications. Numerous studies since the development work were based on data collected within routine clinical practice, including research on the Cognitive Performance Scale,2 Clinical Assessment Protocols,3,4 and quality indicators.5