Benchmarking clinical indicators of quality for Australian residential aged care facilities
Mary Courtney A , Maria T. O’Reilly A C , Helen Edwards A and Stacey Hassall BA Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD 4059, Australia.
B Disability, Community Care Services and Multicultural Affairs, Queensland, GPO Box 806, Brisbane, QLD 4001, Australia.
C Corresponding author. Email: m2.oreilly@qut.edu.au
Australian Health Review 34(1) 93-100 https://doi.org/10.1071/AH09663
Submitted: 17 June 2008 Accepted: 9 March 2009 Published: 25 March 2010
Abstract
To undertake exploratory benchmarking of a set of clinical indicators of quality care in residential care in Australia, data were collected from 107 residents within four medium-sized facilities (40–80 beds) in Brisbane, Australia. The proportion of residents in each sample facility with a particular clinical problem was compared with US Minimum Data Set quality indicator thresholds. Results demonstrated variability within and between clinical indicators, suggesting breadth of assessment using various clinical indicators of quality is an important factor when monitoring quality of care. More comprehensive and objective measures of quality of care would be of great assistance in determining and monitoring the effectiveness of residential aged care provision in Australia, particularly as demands for accountability by consumers and their families increase.
What is known about the topic? The key to quality improvement is effective quality assessment, and one means of evaluating quality of care is through clinical outcomes. The Minimum Data Set quality indicators have been credited with improving quality in United States nursing homes.
What does this paper add? The Clinical Care Indicators Tool was used to collect data on clinical outcomes, enabling comparison of data from a small Australian sample with American quality benchmarks to illustrate the utility of providing guidelines for interpretation.
What are the implications for practitioners? Collecting and comparing clinical outcome data would enable practitioners to better understand the quality of care being provided and whether practices required review. The Clinical Care Indicator Tool could provide a comprehensive and systematic means of doing this, thus filling a gap in quality monitoring within Australian residential aged care.
Acknowledgements
This project was made possible through funding from Blue Care (Brisbane), and the Queensland University of Technology Strategic Linkages Scheme.
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A The MDS does not have a specific QI for chemical restraint; however, the MDS indicator ‘anti-psychotic use, in the absence of psychotic & related conditions’ is considered a proxy measure, as antipsychotic medications are often used for purposes of chemical restraint or behaviour management in people with behavioural disorders resultant from dementia.
Appendix. Sample question from the Clinical Care Indicators Tool
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