scholarly journals The Registry of Senior Australians outcome monitoring system: quality and safety indicators for residential aged care

2020 ◽  
Vol 32 (8) ◽  
pp. 502-510 ◽  
Author(s):  
Maria C Inacio ◽  
Catherine Lang ◽  
Gillian E Caughey ◽  
Sarah C E Bray ◽  
Stephanie L Harrison ◽  
...  
Keyword(s):  
Emergency Department ◽  
Weight Loss ◽  
Premature Mortality ◽  
Antibiotic Use ◽  
Aged Care ◽  
Residential Aged Care ◽  
Quality And Safety ◽  
Opioid Use ◽  
Outcome Monitoring ◽  
Chronic Opioid Use

Abstract Objectives To introduce the Registry of Senior Australians (ROSA) Outcome Monitoring System, which can monitor the quality and safety of care provided to individuals accessing residential aged care. Development and examination of 12 quality and safety indicators of care and their 2016 prevalence estimates are presented. Design Retrospective. Setting 2690 national and 254 South Australian (SA) aged care facilities. Participants 208 355 unique residents nationally and 18 956 in SA. Main Outcome Measures Risk-adjusted prevalence of high sedative load, antipsychotic use, chronic opioid use, antibiotic use, premature mortality, falls, fractures, medication-related adverse events, weight loss/malnutrition, delirium and/or dementia hospitalisations, emergency department presentations, and pressure injuries. Results Five indicators were estimated nationally; antibiotic use (67.5%, 95% confidence interval (CI): 67.3–67.7%) had the highest prevalence, followed by high sedative load (48.1%, 95% CI: 47.9–48.3%), chronic opioid use (26.8%, 95% CI: 26.6–26.9%), antipsychotic use (23.5%, 95% CI: 23.4–23.7%) and premature mortality (0.6%, 95% CI: 0.6–0.7%). Seven indicators were estimated in SA; emergency department presentations (19.1%, 95% CI: 18.3–20.0%) had the highest prevalence, followed by falls (10.1%, 95% CI: 9.7–10.4%), fractures (4.8%, 95% CI: 4.6–5.1%), pressure injuries (2.9%, 95% CI: 2.7–3.1%), delirium and/or dementia related hospitalisations (2.3%, 95% CI: 2.1–2.6%), weight loss/malnutrition (0.7%, 95% CI: 0.6–0.8%) and medication-related events (0.6%, 95% CI: 0.5–0.7%). Conclusions Twelve quality and safety indicators were developed to monitor aged care provided to older Australians based on the synthesis of existing literature and expert advisory input. These indicators rely on existing data within the aged care and healthcare sectors, therefore creating a pragmatic tool to examine quality and unwarranted care variation.

Public sector residential aged care: identifying novel associations between quality indicators and other demographic and health-related factors

2014 ◽  
Vol 38 (3) ◽  
pp. 325 ◽  
Author(s):  
Kirsten J. Moore ◽  
Colleen J. Doyle ◽  
Trisha L. Dunning ◽  
Ann T. Hague ◽  
Lucas A. Lloyd ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Cognitive Impairment ◽  
Adverse Events ◽  
Regression Models ◽  
Aged Care ◽  
Residential Aged Care ◽  
Risk Of Falling ◽  
Related Factors ◽  
Health Related

Objective To explore associations among quality indicators (QI; e.g. pressure ulcers, falls and/or fractures, physical restraint, use of multiple medications, unplanned weight loss) of the Victorian Public Sector Residential Aged Care Services (VPSRACS) with other demographic and health-related factors. Methods Data for 380 residents over a 3-month period were extracted retrospectively from client databases at four VPSRAC facilities. Results Four significant logistic regression models were developed. The strongest models related to falls and polypharmacy. Significant associations for these models included the following: (1) residents with a higher body mass index were 6% less likely (95% confidence interval (CI) 1%–11%) to fall, whereas high levels of cognitive impairment increased the risk of falling by 8% (95% CI 2%–14%); (2) being ambulant with a gait aid more than doubled the risk of falling compared with non-ambulant residents (95% CI 19%–546%); and (3) higher cognitive impairment was associated with a 6% (95% CI 1%–11%) reduction in the likelihood of polypharmacy. Conclusions Identification of significant relationships between the VPSRACS QI and other demographic and health-related factors is a preliminary step towards a more in-depth understanding of the factors that influence the QI and predict adverse events. What is known about the topic? Currently, the VPSRACS report on five QI. Previous research has shown associations between several of these indicators, but not all. What does this paper add? This paper examines associations between the five VPSRAC QI as well as other key demographic and health-related factors. Novel findings from regression analyses included an increased risk of falls associated with recommended body mass index and using gait aids, but no association between pressure ulcers and the Norton score. Regression models for other QI were limited by the small occurrences of the QI. However, significant associations were identified indicating that residents using a gait aid had a lower level of unplanned weight loss and residents with polypharmacy had higher unplanned weight loss. What are the implications for practitioners? This paper reinforces the value of collecting VPSRAC QI data to enable facilities to consider how these variables could impact on care quality and to proactively plan to reduce the risk of adverse events. Although QI data can be used to benchmark with other settings, this paper shows how QI data can be used to inform practice within a facility and help identify patient-related factors that may warrant further investigation.

scholarly journals Injury-Related Emergency Department Presentations Among Residential Aged Care Residents in Victoria, Australia

2021 ◽  
pp. 089826432110392
Author(s):  
Ladan Yeganeh ◽  
Lyndal Bugeja ◽  
Janneke Berecki ◽  
Adrian Laughlin ◽  
Joseph Ibrahim
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Aged Care ◽  
Population Based ◽  
Direct Access ◽  
Residential Aged Care ◽  
Care Services ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities ◽  
Minimum Dataset

Objective This study aimed to quantify and describe the characteristics of emergency department (ED) injury presentations and subsequent hospital admissions among residents of residential aged-care facilities (RACFs) in Victoria, Australia between 2008 and 2018. Methods This study comprised a single jurisdiction population-based study of consecutive injury-related ED presentations of RACFs residents using the Victorian Emergency Minimum Dataset (VEMD). Results The rate of ED injury presentations per 100,000 population decreased by .8% per year over 10 years ( P = .03); however, the rate per 100,000 RACF bed days increased by .6% per year ( P = .05). The proportion of presentations subsequently admitted to hospital increased 4.0% per year ( P<.0001). The majority of presentations were due to falls (82.5%), with fracture(s) being the most common injury type (34.0%). Discussion The increased rate of ED visits and hospital admissions in RACFs residents highlights the need to design specialized emergency care services and/or provide better direct access to hospital care for this vulnerable population.

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