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Measuring safety in older adult care homes: a scoping review of the international literature
- Authors:
- RAND Stacey, et al
- Journal article citation:
- BMJ Open, 11(3), 2021, p.e043206. Online only
- Publisher:
- BMJ Publishing Group
Background: Safety is a key concern in older adult care homes. However, it is a less developed concept in older adult care homes than in healthcare settings. As part of study of the collection and application of safety data in the care home sector in England, a scoping review of the international literature was conducted. Objectives The aim of the review was to identify measures that could be used as indicators of safety for quality monitoring and improvement in older adult residential or nursing care homes. Sources of evidence Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019. Eligibility criteria Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria. Charting methods Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps. Results and conclusions Systematic searches for journal articles published in English language from 1 January 1970, without restriction to the study location or country, were conducted in Web of Science, Scopus and PubMed on 28 July 2019. Inclusion criteria were: peer-reviewed journal articles; qualitative or quantitative studies of older adult nursing and/or residential care homes; and related to any aspect of safety in care homes, including the safety of healthcare provision in the care home. A total of 45 articles were included after review of the title/abstract or full text against the inclusion criteria. Key information was extracted and charted. These findings were then mapped to the Safety Measurement and Monitoring Framework in healthcare (SMMF), adapted by the research team to reflect the care home context, to determine the coverage of different aspects of safety, as well as potential gaps. The findings indicate that there are a range of available safety measures used for quality monitoring and improvement in older adult care homes. These cover all five domains of safety in the SMMF. However, there are potential gaps. These include user experience, psychological harm related to the care home environment, abusive or neglectful care practice and the processes for integrated learning. Some of these gaps may relate to challenges and feasibility of measurement in the care home context. (Edited publisher abstract)
What defines quality of care for older people in aged care? A comprehensive literature review
- Authors:
- CLELAND Jenny, et al
- Journal article citation:
- Geriatrics and Gerontology International, 21(9), 2021, pp.765-778.
- Publisher:
- Wiley
The quality of the care provided to frail older people in aged care is a concern for all Australians and for the citizens of many other countries internationally. This paper summarizes the methods and findings from an Australian study commissioned by the Royal Commission into Aged Care Quality and Safety to identify and synthesize international literature relating to the quality of care in aged care. A comprehensive literature review was undertaken to search and identify the literature (grey and peer reviewed) relating to quality of care and/or person-centered care in aged care. The review identified nine key themes as salient to the quality of care experience, which include treating the older person with respect and dignity; acknowledging and supporting their spiritual, cultural, religious and sexual identity; the skills and training of the aged care staff providing care; relationships between the older person and the aged care staff; social relationships and the community; supporting the older person to make informed choices; supporting the older person's health and well-being; ensuring the delivery of safe care in a comfortable service environment; and the ability to make complaints and provide feedback to the aged care organization. In practice, particularly in the context of residential care, quality of care has traditionally been measured using clinical indicators of care quality. These findings highlight the central importance of person-centered care and care experience as fundamental tenets of the quality of aged care service delivery in Australia and internationally. (Edited publisher abstract)
Measuring satisfaction with social care amongst older service users: issues from the literature
- Authors:
- BAULD Linda, CHESTERMAN John, JUDGE Ken
- Journal article citation:
- Health and Social Care in the Community, 8(5), September 2000, pp.316-324.
- Publisher:
- Wiley
This article highlights some of the main issues to be considered when designing and conducting surveys with older users of community care services. Through a review of British and North American literature the article outlines current approaches to measuring satisfaction and examines the relationship between the characteristics and circumstances of older people and their response to satisfaction questions. Concludes by offering some solutions to overcoming current problems by drawing conclusions about quality from survey findings, to that older people's opinions about the services they receive can be better assessed.
Designing a report card for nursing facilities: what information is needed and why
- Authors:
- HARRINGTON Charlene, et al
- Journal article citation:
- Gerontologist, 43(Special Issue II), April 2003, pp.47-57.
- Publisher:
- Oxford University Press
This article presents a rationale and conceptual framework for making comprehensive consumer information about nursing facilities available. Such information can meet the needs of various stakeholder groups, including consumers, family/friends, health professionals, providers, advocates, ombudsman, payers, and policy makers. The rationale and framework are based on a research literature review of key quality indicators for nursing facilities. The findings show six key areas for information: facility characteristics and ownership; resident characteristics; staffing indicators; clinical quality indicators; deficiencies, complaints, and enforcement actions; and financial indicators. This information can assist in selecting, monitoring, and contracting with nursing facilities. Model information systems can be designed using existing public information, but the information needs to be enhanced with improved data.
An assessment of strategies for improving quality of care in nursing homes
- Author:
- WEINER Joshua M.
- Journal article citation:
- Gerontologist, 43(Special Issue II), April 2003, pp.19-27.
- Publisher:
- Oxford University Press
Despite substantial regulatory oversight, quality of care in nursing homes remains problematic. This article assesses strategies for improving quality of care in these facilities. This article reviews the research literature on eight strategies: strengthening the regulatory process, improving information systems for quality monitoring, strengthening the caregiving workforce, providing consumers with more information, strengthening consumer advocacy, developing and implementing practice guidelines, and changing the culture of nursing facilities. Although individual approaches vary, several themes emerge. First, several strategies require substantially more resources and will increase costs. Second, the research literature does not provide much guidance as to the effectiveness of these options. Third, several strategies assume a degree of data sophistication on the part of nursing homes that may not exist. Fourth, regulation is likely to continue to be the main strategy of quality assurance. Finally, the political saliency of nursing home quality issues is uneven.
Learning for care homes from alternative residential care settings: report
- Authors:
- BURTNEY Liz, et al
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2014
- Pagination:
- 72
- Place of publication:
- York
This review uses a rapid evidence assessment to investigate the scope for improving the quality of care provided by residential care homes in the United Kingdom through learning from other providers. The review focused on three settings: residential services for children and young people; residential services and supported housing for people with learning disabilities; and hospice care. The review looked at the international and national literature, evaluations and opinions of people using services; and feedback from frontline practitioners on the accuracy of findings and transferability of learning from others. Findings are discussed in the following areas: regulation, risk management, safeguarding, person-centred approaches, co-ordination of care and advanced care planning, staff selection and skills, and ongoing support for staff. The report found that although evidence of effectiveness is limited, there are promising ideas that could improve the culture of care homes, experiences of care and support for staff. It presents evidence of how residential care homes in other sectors have created positive organisational cultures and increased relationship-based care to improve the quality of care offered. It also discusses how how greater involvement of people who use services and their families can improve experiences of care. Examples of practice are included throughout the report. (Edited publisher abstract)