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Improving nursing home quality of care through outcomes data: the MDS quality indicators
- Author:
- ZIMMERMAN David R.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(3), March 2003, pp.250-257.
- Publisher:
- Wiley
The quality of care provided to nursing home residents is a continuing source of concern throughout the world. In the United States, the Health Care Financing Administration mandated the use of a standardised resident assessment instrument, called the Minimum Data Set (MDS) which facilitated the development of a set of nursing home quality of care indicators. The MDS Quality Indicators were developed by a team of researchers and covered 12 domains, as well as associated risk factors. This initial set of indicators then went through an iterative process of review by national clinical panels, further empirical analysis, validation studies, and pilot tests, to confirm whether they were accurate, reliable and useful tools for identifying quality problems. The final set of MDS Quality Indicators includes 24 variables that include both processes and outcomes of care and prevalence and incidence measures. They are defined at both the resident and facility level. Four of the indicators are risk-adjusted. The indicators have several possible applications: a source of consumer information; to help guide policy makers; and to assist providers in conducting quality improvement initiatives and to evaluate the impact of these efforts.
Benchmarking and quality in residential and nursing homes: lessons from the US
- Authors:
- MOR Vincent, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(3), March 2003, pp.258-266.
- Publisher:
- Wiley
Performance measurement and benchmarking are common concerns in the delivery of long term care. It is common to measure the performance of providers and to publicly report these data. This paper examines selected technical challenges facing those who design, implement and disseminate health care quality performance measures. The article reviews the application of measures of performance in the US nursing home sector. Using examples drawn from the skilled nursing home arena, problems ranging from data reliability and validity, the multi-dimensional nature of quality measures and selection bias as well as differential measurement abilities are discussed. Benchmarking of performance is an inherently complex issue. However, to ensure that such comparisons are both fair and valid requires measures to be more technically sophisticated and sensitive to real changes attributable to changes in care.
Dimensions of choice in the assessment and care management process: the views of older people, carers and care managers
- Authors:
- HARDY Brian, YOUNG Ruth, WISTOW Gerald
- Journal article citation:
- Health and Social Care in the Community, 7(6), November 1999, pp.483-491.
- Publisher:
- Wiley
The aim of promoting choice for service users and carers is, together with the goal of greater independence, central to recent community care policies. This article sets out a typology of those key choices which users and carers are expected to be able to make within each stage of the assessment and care management process. The article goes on to describe the extent to which such choices have increased or decreased in practice. The evidence confirms that of other recent studies that the gap between the 'ideal' or user and carer involvement and the 'reality' of everyday practice is still considerable.
PLANEC - Information based care for elderly people
- Authors:
- VAARAMA Marja, VOUTILAINEN Lic Paivi
- Journal article citation:
- New Technology in the Human Services, 12(1/2), 1999, pp.125-129.
- Publisher:
- Centre for Human Service Technology
The article describes the development process of PLANEC Performance Management System that was carried out by launching a European research project during 1996 and 1998. The PLANEC system is used in Finland as a tool for planning, monitoring and evaluation of the care of the elderly to achieve a balance of care by matching needs to resources. The theoretical frame, structure of the system as well as thorough validation process are discussed in detail.
Daybreak home care and companion service: elderly; report - year four April 1991-March 1992
- Author:
- DAYBREAK
- Publisher:
- Daybreak
- Publication year:
- 1992
- Pagination:
- 55p.
- Place of publication:
- Cardiff
Report of a project run by a voluntary organisation providing care and support services for older and disabled people and their carers. Describes the project, gives an account of progress in year four and looks at care management, performance measures, statistical data, cost benefit and financial data and issues regarding the independent sector. Goes on to detail future plans, priorities and performance measures.
National performance indicator: increase the percentage of people aged 65 and over with high levels of care needs who are cared for at home: summary
- Authors:
- MACINTYRE Gillian, STEWART Ailsa
- Publisher:
- Institute for Research and Innovation in Social Services
- Publication year:
- 2011
- Pagination:
- 6p., bibliog.
- Place of publication:
- Glasgow
One of the Scottish government's 45 indicators of success in achieving national outcomes identified in the National Performance Framework relates to supporting older people with complex needs to remain at home. A review was undertaken to provide an overview of the best available evidence about what works in increasing the percentage of people aged 65 and over with high-level care needs who are cared for at home. This summary sets out the practice issues identified, covering: assessment and care management (including single shared assessment), specialist services to shift the balance of care (including homecare reablement, admission prevention and/or supported discharge models, delayed discharge and people with dementia, intermediate care, rapid response teams, and falls prevention and intermediate care), long term services to maintain people at home (including homecare, and homecare and daycare for people with dementia), innovations (including telecare), and the implications of maintaining older people at home (including costs, carers and workforce).
National performance indicator: increase the percentage of people aged 65 and over with high levels of care needs who are cared for at home
- Authors:
- MACINTYRE Gillian, STEWART Ailsa
- Publisher:
- Institute for Research and Innovation in Social Services
- Publication year:
- 2011
- Pagination:
- 70p., bibliog.
- Place of publication:
- Glasgow
One of the Scottish government's 45 indicators of success in achieving national outcomes identified in the National Performance Framework relates to supporting older people with complex needs to remain at home. This review was undertaken to provide an overview of the best available evidence about what works in increasing the percentage of people aged 65 and over with high-level care needs who are cared for at home. The report explains the methodology used and describes the policy context in Scotland. It sets out the findings of the review of research evidence, covering issues, evidence and good practice relating to the practice issues identified: assessment and care management (including single shared assessments and integrated assessments), specialist services to maintain people at home, prevent admission to hospital or increase the speed of discharge (including homecare reablement, admission prevention and/or supported discharge models, and intermediate care), long term services to maintain people at home (including home care, and home care and day care for people with dementia), innovations (including telecare), and the implications of maintaining older people at home (including costs and carers).