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Quality and safety in residential aged care: an evaluation of a national quality indicator programme |
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| Authors: | Maria C. Inacio Tesfahun C. Eshetie Gillian E. Caughey Craig Whitehead Johanna Westbrook Len Gray Peter Hibbert Elizabeth Beattie Jeffrey Braithwaite Ian D. Cameron Maria Crotty Steve Wesselingh |
| Affiliation: | 1. Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia;2. Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia;3. Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia;4. College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia Southern Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia;5. Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia;6. Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia;7. Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia;8. School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia;9. John Walsh Centre for Rehabilitation Research, University of Sydney, Sydney, New South Wales, Australia |
| Abstract: | BackgroundIn Australia, 243 000 individuals live in approximately 2700 residential aged care facilities yearly. In 2019, a National Aged Care Mandatory Quality Indicator programme (QI programme) was implemented to monitor the quality and safety of care in facilities.AimTo examine the validity of the QI programme indicators using explicit measure review criteria.MethodsThe QI programme manual and reports were reviewed. A modified American College of Physicians Measure Review Criteria was employed to examine the QI programme's eight indicators. Five authors rated each indicator on importance, appropriateness, clinical evidence, specifications and feasibility using a nine-point scale. A median score of 1–3 was considered to not meet criteria, 4–6 to meet some criteria and 7–9 to meet criteria.ResultsAll indicators, except polypharmacy, met criteria (median scores = 7–9) for importance, appropriateness and clinical evidence. Polypharmacy met some criteria for importance (median = 6, range 2–8), appropriateness (median = 5, range 2–8) and clinical evidence (median = 6, range 3–8). Pressure injury, physical restraints, significant unplanned weight loss, consecutive unplanned weight loss, falls and polypharmacy indicators met some criteria for specifications validity (all median scores = 5) and feasibility and applicability (median scores = 4 to 6). Antipsychotic use and falls resulting in major injury met some criteria for specifications (median = 6–7, range 4–8) and met criteria for feasibility and applicability (median = 7, range 4–8).ConclusionsAustralia's National QI programme is a major stride towards a culture of quality promotion, improvement and transparency. Measures' specifications, feasibility and applicability could be improved to ensure the programme delivers on its intended purposes. |
| Keywords: | quality indicators residential aged care nursing homes quality improvement quality measurement |