Providers taken through design of new star-rating system

Providers can expect the forthcoming star ratings system for residential aged care to undergo regular improvements over the years to come.

The delivery of Australia’s star-ratings system for residential aged care is near but the sector can expect refinements and improvements over the next five years, providers have heard in an industry webinar this week.

The star-rating system, which was a recommendation of the royal commission, aims to give older Australians and their family members a better way to understand information on the quality of the aged care services they are considering or receiving.

The University of Queensland Centre for Health Services Research, the Aged Care Industry Information Technology Council of Australia and PricewaterhouseCoopers have been working with the Australian Government Department of Health and Aged Care to develop the star-ratings system.

The research, consultation, design and testing stages of development are complete with final refinements continuing ahead of an expected launch in late 2022.

Dr Kim-Huong Nguyen

It has been and continues to be an iterative process, said Dr Kim-Huong Nguyen, a health economist at CHSR in a webinar hosted by the ACIITC on Tuesday.

“We developed the first, I would say, generation of star ratings for Australia. But we do believe that in the next five years, we’ll continue to work with Department of Health [and Aged Care] to improve the data as well as the methodology behind it,” Dr Nguyen told more than 100 aged care stakeholders.

The star ratings are based on:

  • five quality indicators
  • service compliance ratings
  • consumer experience
  • staff care minutes.

The system will provide an overall rating for the home. “Within that, each individual data element or domain will have its own rating,” said Dr Nguyen.

Above: Dr Kim-Huong Nguyen from the University of Queensland Centre for Health Services Research used the slides above to walk aged care stakeholders through the design of the star-ratings systems during an ACIITC webinar

The star-rating system draws on data from the National Aged Care Mandatory Quality Indicator Program, consumer experience reports produced by the Aged Care Quality and Safety Commission and provider compliance with and performance against the Aged Care Quality Standards.

“The staffing time at the moment is based on the idea that the care will be highly correlated with the time that staff will provide care and because of that there should be a minimum requirement. So the policy standard at the moment is an average of 200 minutes per resident per day and that includes an average of 40 minutes of registered nurse time per resident per day.” However, the standard for each home will reflect their particular casemix, she added.

Three of the five quality indicators are risk adjusted, which is an important aspect of the measure, she said. The five scores are combined to achieve a score out of 25. This score will be relefected in a star rating using a matrix of cutoff points, Dr Nguyen said (see slide above).

Similarly, in the consumer experience rating, the answer for each of the questions will be aggregated and matched to a matrix of cutoffs in order to achieve a particular level, she said.

For care minutes, there are two measures. “One is total care minutes and the other is RN minutes,” said Dr Nguyen. “The combination of it should reflect the quality of the care service in a particular facility.”

The last domain is the service compliance rating, which consists of auditing the service and converting to the star. “But this is actually a very straightforward system because it has already run for many years and the data is quite mature,” said Dr Nguyen.

After all of this, the four domains are combined into a star rating. The weight of the components is based on a very comprehensive consultation review with stakeholders, Dr Nguyen said.

Work is continuing on the system because the star ratings will be updated quarterly while the data collected, and the stability and reliability of the algorithm and the methodology will likely be reviewed annually, she said.

“Improvement on the current data collection is essential if we want to use this information to help residents and their family to make a good choice.”

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Tags: aciitc, Kim-Huong Nguyen, star rating system,

2 thoughts on “Providers taken through design of new star-rating system

  1. I could spend an hour with a resident, checking my Facebook or 5 minutes doing an assessment and really listening. Person centred care is about connection and time is only meaningful if you use it meaningfully

  2. Rhonda, I agree. While the causal link between staffing and outcomes for residents is well established. Staffing goes beyond the notion of time spent by a role. The reported comment that total care minutes ‘should reflect the quality of the care service’ warrants some further inquiry. I am always concerned when simplified inputs are said to be presenting an outcome. This is particularly true in human services where the ‘quality’ of the interaction can be so variable. I accept counting minutes has a place but we should be about clear what that means. Put another way ‘are all care minutes equal’ considering the skills, experience, competence and empathy of the carer.

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