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New Aged Care Quality Indicators Commence 1 April 2023: How to Prepare

28/02/23
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The National Aged Care Mandatory Quality Indicator Program (QI Program) started on 1 July 2019 and was updated on 1 July 2021. The mandatory Program requires Commonwealth-subsidised residential aged care services to collect data and report on a set of Quality Indicators (QIs) every three months.

Currently (as at February 2023), services must collect data and report on these five QIs:

  • pressure injuries
  • physical restraint
  • unplanned weight loss (significant and consecutive)
  • falls and major injury
  • medication management, including polypharmacy and anti-psychotics.

The QI Program is expanding to add six new QIs from April 2023. Today we look at what the Department of Health and Aged Care’s updated guidance tells us about the new QIs and the new data that aged care providers must collect and report on.

 

What Are the New QIs?

In addition to the five existing QIs, from April 2023 residential aged care providers will also have to collect data and report on:

  • Activities of daily living (ADL): percentage of care recipients whose ADL function has declined.
  • Incontinence care: percentage of care recipients with incontinence associated dermatitis.
  • Hospitalisations: percentage of care recipients who presented to hospital.
  • Workforce: percentage of staff turnover.
  • Consumer experience: percentage of care recipients who report good or excellent experience of the service.
  • Quality of life: percentage of care recipients who report good or excellent quality of life.

These new QIs were tested in the Department of Health and Aged Care’s recent pilot program.

 

Home Care

At this stage, none of the QIs apply to home care. However, the Department of Health and Aged Care says that they are planning to expand the QI Program into home care. It’s not clear when this will happen.

 

When Do I Have to Start “Collecting” Data and When Do I Have to “Report”?

According to the Department of Health and Aged Care, providers must:

  • start collecting new quality indicators in the April – June 2023 quarter
  • submit quality indicator data in the 1 – 21 July 2023 reporting period.

 

What New Data Do We Have to Collect?

Note on terminology: the requirements below refer to the “current quarter” and “previous quarter”. The current quarter is the quarter that you are in now or which recently finished. The previous quarter is the last quarter that you have reported on. For example, as at February 2023, the current quarter is 1 January to 31 March 2023. The previous quarter is 1 October to 31 December 2022.

You’ll see below that some requirements require you to compare current quarter data against previous quarter data. This could be a problem when you come to report on the new QIs in July because you won’t have any data for the previous quarter (Jan-March), because you weren’t required to collect it. It’s not clear how the Department or Commission will address this problem. ACE will monitor for updates and share them via the Weekly Wrap or ACE as they arise.

 

New QI From 1 April 2023 you must collect:
Activities of daily living (ADL)
  • Number of care recipients assessed for ADL function (this should be all care recipients minus those excluded as per the next dot points).
  • Number of care recipients excluded because they were receiving end-of-life care.
  • Number of care recipients excluded because they were absent from the service for the entire quarter.
  • Number of care recipients excluded because they did not have an ADL assessment total score recorded for the previous quarter. [For the first round of reporting in July 2023, this could be problematic due to providers’ lack of data from the previous quarter.]
  • Number of care recipients with an ADL assessment total score of zero in the previous quarter.
  • Number of care recipients who experienced a decline in ADL assessment total score of one or more points. [For the first round of reporting in July 2023, this could be problematic due to providers’ lack of data from the previous quarter.]

How to collect this data:

Complete a single assessment for each care recipient around the same time every quarter and compare to their ADL assessment total score in the previous quarter to determine decline. [For the first round of reporting in July 2023, this could be problematic due to providers’ lack of data from the previous quarter.]

Incontinence care
  • Number of care recipients assessed for incontinence care (this should be all care recipients minus those excluded as per the next dot points).
  • Number of care recipients excluded because they were absent from the service for the entire quarter.
  • Number of care recipients excluded from Incontinence Associated Dermatitis (IAD) assessment because they did not have incontinence.
  • Number of care recipients with incontinence.
  • Number of care recipients with incontinence who experienced IAD.
  • Number of care recipients with incontinence who experienced IAD, reported against each of the four IAD sub-categories:
  1. 1A: Persistent redness without clinical signs of infection
  2. 1B: Persistent redness with clinical signs of infection
  3. 2A: Skin loss without clinical signs of infection
  4. 2B: Skin loss with clinical signs of infection.

How to collect this data:

Conduct a single assessment for each care recipient, around the same time every quarter as part of routine care.

Hospitalisations
  • Number of care recipients assessed for hospitalisation (this should be all care recipients minus those excluded as per the next dot points).
  • Number of care recipients excluded because they were absent from the service for the entire quarter.
  • Number of care recipients who had one or more emergency department presentations during the quarter.
  • Number of care recipients who had one or more emergency department presentations or hospital admissions during the quarter.

How to collect this data:

Conduct a single review of the care records for each care recipient for the entire quarter.

Workforce

[For the first round of reporting in July 2023, many of the below requirements this could be problematic due to providers’ lack of data from the previous quarter.]

  • Number of staff who worked any hours as care management staff in the previous quarter.
  • Number of staff who worked any hours as nurse practitioners or registered nurses in the previous quarter.
  • Number of staff who worked any hours as enrolled nurses in the previous quarter.
  • Number of staff who worked any hours as personal care staff or assistants in nursing in the previous quarter.
  • Number of staff employed as care management staff at the start of the quarter.
  • Number of staff employed as nurse practitioners or registered nurses at the start of the quarter.
  • Number of staff employed as enrolled nurses at the start of the quarter.
  • Number of staff employed as personal care staff or assistants in nursing at the start of the quarter.
  • Number of staff employed as care management staff who stopped working during the quarter.
  • Number of staff employed as nurse practitioners or registered nurses who stopped working during the quarter.
  • Number of staff employed as enrolled nurses who stopped working during the quarter.
  • Number of staff employed as personal care staff or assistants in nursing who stopped working during the quarter.

How to collect this data:

Conduct a single review of staff records. The collection date must take place in the 21 days after the end of the current quarter, in order to review records for the entire quarter. So, for the first round of reporting, the collection date must be between 1 July and 21 July 2023, inclusive.
Consumer experience
  • Number of care recipients offered a consumer experience assessment through self-completion, interviewer-facilitated completion or proxy-completion (this should be all care recipients minus those excluded as per the next dot points).
  • Number of care recipients excluded because they were absent from the service for the entire quarter.
  • Number of care recipients excluded because they did not choose to complete the Quality of Care Experience Aged Care Consumers (QCE-ACC) for the entire quarter.
  • Number of care recipients who reported consumer experience through each completion mode of the QCE-ACC (self-completion, interviewer-facilitated completion, or proxy-completion), scored against the five categories:
  1. ‘Excellent’ (care recipients who score between 22–24)
  2. ‘Good’ (care recipients who score between 19–21)
  3. ‘Moderate’ (care recipients who score between 14–18)
  4. ‘Poor’ (care recipients who score between 8–13)
  5. ‘Very poor’ (care recipients who score between 0–7).

How to collect this data:

Offer a consumer experience assessment to each care recipient for completion, around the same time every quarter.

Quality of life
  • Number of care recipients offered a quality of life assessment through self-completion, interviewer-facilitated completion or proxy-completion (this should be all care recipients minus those excluded as per the next dot points).
  • Number of care recipients excluded because they were absent from the service for the entire quarter.
  • Number of care recipients excluded because they did not choose to complete the QOL-ACC (Quality of Life Aged Care Consumers) for the entire quarter.
  • Number of care recipients who reported quality of life through each completion mode of the QOL-ACC (self-completion, interviewer- facilitated completion or proxy-completion), scored against the five categories:
  1. ‘Excellent’ (care recipients who score between 22–24)
  2. ‘Good’ (care recipients who score between 19–21)
  3. ‘Moderate’ (care recipients who score between 14–18)
  4. ‘Poor’ (care recipients who score between 8–13)
  5. ‘Very poor’ (care recipients who score between 0–7).

How to collect this data:

Offer a quality of life assessment to each care recipient for completion, around the same time every quarter.

 

How to Report the New Data

Reports are made via the provider portal on My Aged Care the same way you report on the existing five QIs. The first reporting dates for the new QI data will be from 1 July to 21 July 2023.

 

What To Do Now

Providers should begin putting systems in place and allocating resources so that they can collect data for the new QIs in the April-June quarter. Providers should be ready to report on the new QIs by July 2023.

 

Further Resources

 

CompliSpace Aged Care Demo

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About the Author

Mark Bryan

Mark is a Legal Content Consultant at Ideagen CompliSpace and the editor for Aged Care Essentials (ACE). Mark has worked as a Legal Policy Officer for the Commonwealth Attorney-General’s Department and the NSW Department of Justice. He also spent three years as lead editor for the private sessions narratives team at the Royal Commission into Institutional Responses to Child Sexual Abuse. Mark holds a bachelor’s degree in Arts/Law from the Australian National University with First Class Honours in Law, a Graduate Diploma in Writing from UTS and a Graduate Certificate in Film Directing from the Australian Film Television and Radio School.

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