Overview

The Trial Assessment is used to capture facility-based vocational training by the FBVR department..  It captures qualifications for entry into the program and assessments/interview responses pertinent to vocational placement.  Either this document or the Trial Visit Summary Trial Visit Summary  will be used for virtually all Trial Visits.

Applicable Staff

Directors/Supervisors and ID Staff will be able to complete the form and all users will be able to view it.

Usage

The Trial Assessment is client and episode based.  It can be accessed through the Home View, from within a client's chart (Chart View), or by navigating the menu path Mercy Modeled Clinical Forms/Mercy ID Forms/Trial Assessment (MIDS 1211).

The form opens to the general information area and the Checklist for Admissions subsection.  The Assessment Date, Facility and Practitioner fields are required and must be completed to submit the form.

The Interview Questions subsection contains questions to gauge the client's abilities, goals, and employment history.  Interviewer's Impressions allows capturing information about the client's appearance, communication skills attitude towards work, maturity, social skills, and any other pertinent information.

The Initial Assessment is scored in the following manner:

0 = Never     1 = Occasionally     2 = Often     3 = Never

Select the appropriate score by clicking in the radio button corresponding to the most accurate answer.  Any choices made in error can be cleared by selecting that answer and pressing F5 on the keyboard.

The Narrative portion of the assessment describes the following skills as they relate to job contracts and readiness:

Writing Skills

Reading Skills

Numerical Skills

Physical Limitations

Level of Supervision Required

The Simulated Work Checklist subsection captures the results of testing various skills as they relate to job readiness.

The remainder of the form is used to detail further aspects of job readiness such as behavioral needs, instruction capabilities, level of vocational functioning, transportation, a person-centered plan response, and a summary and recommendations.

Click the blue Submit button to save the form and add it to the record.  A report will open and have a signature page included for printing.  Collect all required signatures and send the the HIM Department for scanning into the record.  Details of that process can be found here.  HIM Processes 

Tips & FAQ

Radio buttons can be cleared by selecting the desired entry and pressing F5 on the keyboard.  Check boxes are cleared by clicking the entry again.

The Trial Assessment, along with the Trial Visit Summary, are required documentation for all Trial Visits.

The Trial Assessment is used for the FBVR Program, and the Trial Visit Summary is used for Residential Programs.

Technical Information

Menu Location (Mercy Modeled Clinical Forms/Mercy ID Forms/Trial Assessment (MIDS 1211))

SQL Table(s) - ID_trial_assessment

RAD Envelope - trial_assessment

Related Forms and Reports (data from one form feeds another report/form) - Trial Visit Summary