Falls QI stubbornly steady
The latest report shows clinical quality indicators – except falls – have moved in the right direction over time, highlighting the need for more prevention interventions in residential aged care, says an expert.
There has been a statistically significant decrease in the proportion of aged care residents experiencing almost all clinical indicators measured in the national mandatory program over the last three years – falls is the exception.
Quality indicators, or QIs, aim to measure aspects of service provision that contribute to the quality of care. Since July 2021, under the National Aged Care Mandatory Quality Indicator Program, providers have been required to submit data on five clinical indicators:
- pressure injuries
- use of physical restraint
- unplanned weight loss
- falls and major injury
- medication management
The Residential Aged Care Quality Indicators – April to June 2024 quarterly report published by the Australian Institute of Health and Welfare in late October includes a trend analysis examining the variation in QI performance over the 12 quarters from July-September 2021 to April to June 2024.
It found a statistically significant decrease in almost all of the data points in these QIs. This includes the proportion of residents experiencing polypharmacy, antipsychotic medication use, falls that resulted in major injury, one or more pressure injuries, use of physical restraint, physical restraint exclusively via a secure area, significant unplanned weight loss and consecutive unplanned weight loss.
The results show no statistically significant change in the proportion of residents experiencing falls.
In the April-to-June quarter this year, 67,404 residents had a fall according to the report, which equates to just under a third of all residents (32.6 per cent).
This is the highest proportion of residents across the three years in the analysis. The lowest proportion was five quarters previously – January to March 2023 – where 31 per cent of residents had a fall.
The findings highlight the need for more falls prevention interventions in residential aged care, said Professor Stephen Lord – senior principal research fellow at NeuRA’s Falls, Balance and Injury Research Centre.
“Falls are the leading cause of injury-related death and hospitalisation in people aged 65 years and over,” Professor Lord told Australian Ageing Agenda.
“The rate of falling in older people living in nursing homes is higher than people living in the community and reflected in this report.
“This report draws attention to the need for more falls prevention interventions in aged care, including increased physiotherapy aimed at promoting balance and safe mobility,” he said.
Since April 2023, the QI Program was expanded to include:
- activities of daily living
- incontinence care
- hospitalisations
- workforce
- consumer experience
- quality of life
These QIs will be included in trend analysis when there are six or more quarters of data available, the report’s authors say.
3 new QIs coming
Last month the Department of Health and Aged Care announced residential aged care providers would collect data on three new staffing QIs from April 2025 under the mandatory program. They are:
- enrolled nursing
- allied health
- lifestyle officers.
The QIs will collect:
- the proportion of enrolled nursing care minutes and nursing care minutes
- allied health care minutes and percentage of recommended allied health services received
- lifestyle officer care minutes.
The new QI’s – which will bring the total quality indicators to 14 – aim to measure the role staff have in providing high-quality care.
The department highlighted that data for these quality indicators build on existing reporting where possible.
“For this reason, four of the five new data points will come from the Quarterly Financial Report. This means that providers won’t have any extra reporting for those four data points,” the department said in a communication to providers.
The new staffing quality indicators were informed by consultation, which included feedback from 110 survey participants, 24 responses to a public consultation paper, more than 900 webinar attendees, and a six-week pilot with 69 aged care homes.
Minister for Aged Care Anika Wells said the new staffing quality indicators would put the focus on key roles that support health and wellbeing.
“We are determined to ensure older people have high-quality care that safeguards their health and wellbeing as they age. Quality indicators are one important way we achieve this.”
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