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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

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 B
+ Author Affiliations
- Author Affiliations

A 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.


References


[1] Australian Institute of Health and Welfare. Residential aged care in Australia 2005–06: a statistical overview. Aged Care Statistics Series 24. Canberra: AIHW, 2007. (AIHW Cat. No. AGE 54.)

[2] Department of Health and Ageing. Health and ageing factbook 2006. [Rescinded publication.] Available at http://www.healthyactive.gov.au/internet/main/publishing.nsf/Content/056CE2932CA4D491CA257183008169E2/$File/2006%20Health%20and%20Ageing%20Factbook.pdf [verified 24 July 2007].

[3] O’Reilly M,  Courtney M,  Edwards H. How is quality being monitored in Australian residential aged care facilities? A narrative review. Int J Qual Health Care 2007; 19 177–82.
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[19] Rantz MJ,  Mehr D,  Conn V,  Hicks L,  Porter R,  Madsen RW, et al. Assessing quality of nursing home care: the foundations for improving resident outcomes. J Nurs Care Qual 1996; 10 1–9.
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[20] Rantz MJ,  Hicks L,  Petroski GF,  Madsen RW,  Mehr DR,  Conn V, et al. Stability and sensitivity of nursing home quality indicators. J Gerontol A – Biol Sci Med Sci 2004; 59 79–82.
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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


Appendix.  Sample question from the Clinical Care Indicators Tool
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