The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study)
Abstract Background This study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) recommendations. Methods Sixteen conditions/process...
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| Format: | Article |
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BMC
2024-01-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-023-03224-8 |
| _version_ | 1797276448213434368 |
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| author | Peter D. Hibbert Charlotte J. Molloy Ian D. Cameron Leonard C. Gray Richard L. Reed Louise K. Wiles Johanna Westbrook Gaston Arnolda Rebecca Bilton Ruby Ash Andrew Georgiou Alison Kitson Clifford F. Hughes Susan J. Gordon Rebecca J. Mitchell Frances Rapport Carole Estabrooks Gregory L. Alexander Charles Vincent Adrian Edwards Andrew Carson-Stevens Cordula Wagner Brendan McCormack Jeffrey Braithwaite |
| author_facet | Peter D. Hibbert Charlotte J. Molloy Ian D. Cameron Leonard C. Gray Richard L. Reed Louise K. Wiles Johanna Westbrook Gaston Arnolda Rebecca Bilton Ruby Ash Andrew Georgiou Alison Kitson Clifford F. Hughes Susan J. Gordon Rebecca J. Mitchell Frances Rapport Carole Estabrooks Gregory L. Alexander Charles Vincent Adrian Edwards Andrew Carson-Stevens Cordula Wagner Brendan McCormack Jeffrey Braithwaite |
| author_sort | Peter D. Hibbert |
| collection | DOAJ |
| description | Abstract Background This study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) recommendations. Methods Sixteen conditions/processes of care amendable to estimating evidence-based care at a population level were identified from prevalence data and CPGs. Candidate recommendations (n = 5609) were extracted from 139 CPGs which were converted to indicators. National experts in each condition rated the indicators via the RAND-UCLA Delphi process. For the 16 conditions, 236 evidence-based care indicators were ratified. A multi-stage sampling of LTC facilities and residents was undertaken. Trained aged-care nurses then undertook manual structured record reviews of care delivered between 1 March and 31 May 2021 (our record review period) to assess adherence with the indicators. Results Care received by 294 residents with 27,585 care encounters in 25 LTC facilities was evaluated. Residents received care for one to thirteen separate clinical conditions/processes of care (median = 10, mean = 9.7). Adherence to evidence-based care indicators was estimated at 53.2% (95% CI: 48.6, 57.7) ranging from a high of 81.3% (95% CI: 75.6, 86.3) for Bladder and Bowel to a low of 12.2% (95% CI: 1.6, 36.8) for Depression. Six conditions (skin integrity, end-of-life care, infection, sleep, medication, and depression) had less than 50% adherence with indicators. Conclusions This is the first study of adherence to evidence-based care for people in LTC using multiple conditions and a standardised method. Vulnerable older people are not receiving evidence-based care for many physical problems, nor care to support their mental health nor for end-of-life care. The six conditions in which adherence with indicators was less than 50% could be the focus of improvement efforts. |
| first_indexed | 2024-03-07T15:28:22Z |
| format | Article |
| id | doaj.art-08cb650470204549ac984048f4b07f7c |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-03-07T15:28:22Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-08cb650470204549ac984048f4b07f7c2024-03-05T16:32:23ZengBMCBMC Medicine1741-70152024-01-0122111510.1186/s12916-023-03224-8The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study)Peter D. Hibbert0Charlotte J. Molloy1Ian D. Cameron2Leonard C. Gray3Richard L. Reed4Louise K. Wiles5Johanna Westbrook6Gaston Arnolda7Rebecca Bilton8Ruby Ash9Andrew Georgiou10Alison Kitson11Clifford F. Hughes12Susan J. Gordon13Rebecca J. Mitchell14Frances Rapport15Carole Estabrooks16Gregory L. Alexander17Charles Vincent18Adrian Edwards19Andrew Carson-Stevens20Cordula Wagner21Brendan McCormack22Jeffrey Braithwaite23Australian Institute of Health Innovation, Macquarie UniversityAustralian Institute of Health Innovation, Macquarie UniversityJohn Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, Faculty of Medicine and Health, University of Sydney, Kolling InstituteCentre for Health Services Research, Faculty of Medicine, The University of Queensland, Princess Alexandra Hospital CampusDiscipline of General Practice, College of Medicine and Public Health, Flinders UniversityAustralian Institute of Health Innovation, Macquarie UniversityAustralian Institute of Health Innovation, Macquarie UniversityAustralian Institute of Health Innovation, Macquarie UniversityAustralian Institute of Health Innovation, Macquarie UniversityAustralian Institute of Health Innovation, Macquarie UniversityAustralian Institute of Health Innovation, Macquarie UniversityCaring Futures Institute, College of Nursing and Health Sciences, Flinders UniversityAustralian Institute of Health Innovation, Macquarie UniversityCaring Futures Institute, College of Nursing and Health Sciences, Flinders UniversityAustralian Institute of Health Innovation, Macquarie UniversityAustralian Institute of Health Innovation, Macquarie UniversityFaculty of Nursing, University of Alberta, Edmonton Clinic Health AcademyColumbia University School of NursingDepartment of Experimental Psychology, Radcliffe Observatory, University of OxfordPRIME Centre Wales & Division of Population Medicine, Cardiff UniversityPRIME Centre Wales & Division of Population Medicine, Cardiff UniversityNetherlands Institute for Health Services ResearchThe Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of SydneyAustralian Institute of Health Innovation, Macquarie UniversityAbstract Background This study estimated the prevalence of evidence-based care received by a population-based sample of Australian residents in long-term care (LTC) aged ≥ 65 years in 2021, measured by adherence to clinical practice guideline (CPG) recommendations. Methods Sixteen conditions/processes of care amendable to estimating evidence-based care at a population level were identified from prevalence data and CPGs. Candidate recommendations (n = 5609) were extracted from 139 CPGs which were converted to indicators. National experts in each condition rated the indicators via the RAND-UCLA Delphi process. For the 16 conditions, 236 evidence-based care indicators were ratified. A multi-stage sampling of LTC facilities and residents was undertaken. Trained aged-care nurses then undertook manual structured record reviews of care delivered between 1 March and 31 May 2021 (our record review period) to assess adherence with the indicators. Results Care received by 294 residents with 27,585 care encounters in 25 LTC facilities was evaluated. Residents received care for one to thirteen separate clinical conditions/processes of care (median = 10, mean = 9.7). Adherence to evidence-based care indicators was estimated at 53.2% (95% CI: 48.6, 57.7) ranging from a high of 81.3% (95% CI: 75.6, 86.3) for Bladder and Bowel to a low of 12.2% (95% CI: 1.6, 36.8) for Depression. Six conditions (skin integrity, end-of-life care, infection, sleep, medication, and depression) had less than 50% adherence with indicators. Conclusions This is the first study of adherence to evidence-based care for people in LTC using multiple conditions and a standardised method. Vulnerable older people are not receiving evidence-based care for many physical problems, nor care to support their mental health nor for end-of-life care. The six conditions in which adherence with indicators was less than 50% could be the focus of improvement efforts.https://doi.org/10.1186/s12916-023-03224-8Quality of careAged careEvidence-based careLong-term careClinical auditHealthcare quality indicators |
| spellingShingle | Peter D. Hibbert Charlotte J. Molloy Ian D. Cameron Leonard C. Gray Richard L. Reed Louise K. Wiles Johanna Westbrook Gaston Arnolda Rebecca Bilton Ruby Ash Andrew Georgiou Alison Kitson Clifford F. Hughes Susan J. Gordon Rebecca J. Mitchell Frances Rapport Carole Estabrooks Gregory L. Alexander Charles Vincent Adrian Edwards Andrew Carson-Stevens Cordula Wagner Brendan McCormack Jeffrey Braithwaite The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study) BMC Medicine Quality of care Aged care Evidence-based care Long-term care Clinical audit Healthcare quality indicators |
| title | The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study) |
| title_full | The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study) |
| title_fullStr | The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study) |
| title_full_unstemmed | The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study) |
| title_short | The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged study) |
| title_sort | quality of care delivered to residents in long term care in australia an indicator based review of resident records caretrack aged study |
| topic | Quality of care Aged care Evidence-based care Long-term care Clinical audit Healthcare quality indicators |
| url | https://doi.org/10.1186/s12916-023-03224-8 |
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