clinical focus
meaningful for the residents and individually tailored? Are there
activities that make the residents feel valued?
We’ve demonstrated that we can get a summary score from
this instrument which is directly related to the quality of life of the
resident using standardised quality of life measures.
How would providers engage with the questionnaire? How do
you see it being used across facilities?
Well, the questionnaire is freely available. It can be used by facilities
to get feedback from residents and their families on how well
they’re doing. We know that many care providers feel they’re
doing a great job in providing really high quality care, but to
be able to get a quantitative measure of that fed back from the
consumers is really valuable. And this is a simple questionnaire,
so it can actually be completed by residents, even those with mild
cognitive impairment, or their family members. So the facilities
themselves could use this tool to gain some feedback and monitor
whether changes in the types of care they provide are valued
by consumers.
Ideally, we’d like it to be used nationwide, and facilities could
benchmark themselves against each other and strive to improve
the quality of care in a way that is valued by consumers.
In what other ways do you envision the index being used? You
mentioned benchmarking might be one avenue.
Yes. Associate Professor Craig Whitehead and myself appeared at
the Senate inquiry hearing. We know that existing accreditation
systems in the past haven’t always prevented failures in care. So
we’d like to suggest that going into the future, there really needs
to be more consumer input on a routine, regular basis into the
monitoring of aged care, but also as part of a more comprehensive
self-governing aged care sector.
Consumer ratings, if they were used nationwide, could
potentially be made public. They could be benchmarked and
compared against equivalent aged care providers, and this could
be made available and fed back to the providers, so they could see
how they’re performing compared to other aged care providers.
And also consumers could access this information, and high
quality providers would be able to be identified, and also those
who aren’t performing so well could use that to know that they
need to incorporate some other things in their provision of care to
help improve their quality.
What was your pitch when presenting the index to the Senate
inquiry? How might it address some of the issues behind the
initiation of the inquiry, namely the reported incidents in the
Makk & McLeay aged mental healthcare service at Oakden?
We did talk about how there is a lack of public information on
data, but also historically things are very focused on assessor
ratings of quality of care clinical measures. Internationally there is
a move to greater recognition of consumers, residents and family
members in providing input on monitoring quality of care.
So, for example, we did talk about how providing meaningful
activities to residents can be helpful in terms of behavioural and
psychological symptoms of dementia. Had we had a consumer
rating of the quality of aged care, the provision of those type of
activities would impact on the consumer rating of the tool, and
therefore those who weren’t performing so well would certainly
rate much lower on the scale, and this would be apparent,
separate to any clear, purely clinical adverse event monitoring or a
complaint system.
How does the questionnaire differ from other tools that
measure quality of care?
Many of them are very lo ng, and onerous, and have a large
number of questions. This item only includes six, and in particular
we’ve done a lot of scientific validation of this tool. We know it’s
associated with other measures of quality of life. We’ve developed
a scoring algorithm, again, which is evidenced based, and comes
from consumers themselves, that can take the questionnaire, and
using this algorithm, weight the different items and get a summary
score on a scale of zero to one. And again, we have a different
scoring algorithm for both residents who can self-report the
quality of care of family members. So the main difference is it is
both simple and highly scientifically validated.
Is there anything else you would like to add about the index?
I think aged care providers recognise that they want to know
when they’re performing well, and they want to know the
consumer views of having that feedback, so they themselves
can regulate and improve their performance. And this tool is
simple. It’s been tested with more than 500 residents who have
cognitive impairment and dementia, and their families. And it’s
available to be used to consider the quality of care within aged
care facilities. ■
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