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Type: Journal article
Title: The Registry of Senior Australians outcome monitoring system: quality and safety indicators for residential aged care
Author: Inacio, M.C.
Lang, C.
Caughey, G.E.
Bray, S.C.E.
Harrison, S.L.
Whitehead, C.
Visvanathan, R.
Evans, K.
Corlis, M.
Cornell, V.
Wesselingh, S.
Citation: International Journal for Quality in Health Care, 2020; 32(8):502-510
Publisher: Oxford University Press (OUP)
Issue Date: 2020
ISSN: 1353-4505
Statement of
Maria C. Inacio, Catherine Lang, Gillian E. Caughey, Sarah C. E. Bray, Stephanie L. Harrison, Craig Whitehead, Renuka Visvanathan, Keith Evans, Megan Corlis, Victoria Cornell, Steve Wesselingh
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 twelve quality and safety indicators of care and their 2016 prevalence estimates are presented. DESIGN:Retrospective. SETTING:2,690 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 health care sectors, therefore creating a pragmatic tool to examine quality and unwarranted care variation.
Keywords: aged care
quality and safety indicators
quality improvement
Description: Advance Access Publication Date: 21 July 2020
Rights: © The Author(s) 2020. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved.
DOI: 10.1093/intqhc/mzaa078
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