Maria C Inacio1,2, Catherine Lang1, Gillian E Caughey1,2, Sarah C E Bray1, Stephanie L Harrison1,3, Craig Whitehead4,5, Renuka Visvanathan6,7, Keith Evans1, Megan Corlis8, Victoria Cornell9, Steve Wesselingh10. 1. Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia. 2. Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia. 3. Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, L697ZX, UK. 4. Rehabilitation, Aged and Extended Care, Flinders University, Bedford Park, SA 5042, Australia. 5. Division of Rehabilitation, Aged Care and Palliative Care, Southern Adelaide Local Health Network, Bedford Park, SA 5042, Australia. 6. National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing and Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia. 7. Aged and Extended Care Services, Central Adelaide Local Health Network, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia. 8. Helping Hand Inc, Adelaide, SA 5006, Australia. 9. ECH Inc, Parkside, SA 5063, Australia. 10. South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia.
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.
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.
Authors: Janet K Sluggett; Gillian E Caughey; Tracy Air; Max Moldovan; Catherine Lang; Grant Martin; Stephen R Carter; Shane Jackson; Andrew C Stafford; Steve L Wesselingh; Maria C Inacio Journal: Age Ageing Date: 2022-07-01 Impact factor: 12.782
Authors: Monica Cations; Catherine E Lang; Stephanie A Ward; Maria Crotty; Craig Whitehead; John Maddison; Maria Inacio Journal: BMJ Open Date: 2021-02-01 Impact factor: 2.692
Authors: Maria C Inacio; Max Moldovan; Craig Whitehead; Janet K Sluggett; Maria Crotty; Megan Corlis; Renuka Visvanathan; Steve Wesselingh; Gillian E Caughey Journal: BMC Geriatr Date: 2021-12-07 Impact factor: 3.921