How is quality being monitored in Australian residential aged care facilities? A narrative review.

BACKGROUND: 'Quality of Care' is a difficult concept to measure, particularly within the context of residential aged care, which involves lifestyle issues as much as health issues. Recent years have seen an increased focus on quality within residential aged care. Yet, Australia does not have a structured and comprehensive quality monitoring system within this sector. PROBLEM: While the Australian Accreditation Standards have been credited with contributing to improving care since their introduction in 1998, they are only considered to represent minimum (rather than optimal) standards of quality, and they do not sufficiently focus on clinical outcomes. Further, individual facilities might only be assessed against these standards every 3 years; within that time, there is much scope for quality variations to go unnoticed. IMPLICATIONS: This paper contends that collecting and analysing comprehensive clinical data from aged care facility residents constitutes an essential step in the process of monitoring quality in this environment. Such data can be used to formulate indicators of quality, that is, to create markers to highlight areas of clinical care that might be of questionable (or exceptional) quality, enabling more detailed investigations of care practices within a facility. CONCLUSIONS: The above processes could thus fill the current gap in quality monitoring that exists within the Australian residential aged care system, thus ensuring the provision of best-practice care to this vulnerable population.