Quality indicators: the future of aged care if done well
FROM 1 July 2019 reporting of clinical quality indicators for all Australian Government subsidised residential aged care providers will be mandatory.
Mandatory is the important word, because generally speaking aged care providers do nothing on a voluntary basis.
The three quality indicators (pressure injuries, use of physical restraint and unplanned weight loss) have formed part of a voluntary scheme for a number of years. They are being used in Victorian Government-run nursing homes on a mandatory basis, but not many nursing homes besides those are participating.
Briefly, a quality indicator is systematically and periodically collected information about a particular issue in a nursing home. This information is collected in all nursing homes across the country. This allows for the performance of nursing homes to be compared on this particular issue. It’s a comparison, though. It only shows which nursing home is doing better or worse than others.
Quality indicators are therefore not replacements for standards.
CPSA welcomes the introduction of quality indicators by the Australian Government and appreciates that a fully-developed and well-functioning system of an adequate number of aged care quality indicators will take time to be established.
However, CPSA questions the wisdom of introducing a quality indicator for physical restraints while delaying the introduction of a quality indicator for chemical restraints. Providers will feel under pressure to keep physical restraints to an absolute minimum and this may lead to preventable falls. It may also lead to more chemical restraints being used, because these are not monitored.
Chemical restraints are medications to control aggressive behaviour and wandering, but are often prescribed to improve people’s mental state.
It is obvious that a quality indicator for physical restraints should have been paired with a quality indicator for these medications.
The first data will be published by the end of 2019. Ominously, publication details are to be determined in consultation with the aged care sector which will do everything in its power to delay publication and make what is published confusing.