Development of person-centred quality indicators for aged care assessment services in Australia: A mixed methods study.

Publisher: Wiley Country of Publication: England NLM ID: 9815926 Publication Model: Print Cited Medium: Internet ISSN: 1369-7625 (Electronic) Linking ISSN: 13696513 NLM ISO Abbreviation: Health Expect Subsets: MEDLINE

Original Publication: Oxford, UK : Wiley, c1998-

Patient-Centered Care* ; Quality Indicators, Health Care* ; Focus Groups*; Humans ; Australia ; Aged ; Male ; Female ; Health Services for the Aged/standards ; Health Services for the Aged/organization & administration ; Qualitative Research ; Geriatric Assessment/methods

Introduction: This study developed a proposed set of person-centred quality indicators (PC-QIs) for services that assess older adults' care and support needs to determine their eligibility to receive government-funded aged care services in Australia. Individual proposed PC-QIs amenability for change within current organizational structures were explored. Barriers and opportunities to adapt service elements of the aged care assessment service to better align with the intent of the proposed PC-QIs were identified.
Methods: A mixed methods study was conducted over five phases. A scoping review identified domains of quality for aged care services as perceived by older adults. Service elements of an aged care assessment service were mapped alongside quality domains informing key attributes of each quality domain. Self-determination theory was used to formulate each proposed PC-QI to align with key attributes and quality domains. Consultation with a consumer group enabled revision of the proposed PC-QIs. A focus group with clinicians evaluated the amenability of each proposed PC-QI for change and identified barriers and opportunities to better align service elements with older adults' perceptions of quality. Results were informed by qualitative and quantitative data from a structured focus group. Focus group discussions were audio recorded and subsequently transcribed verbatim. Qualitative data were analyzed using a deductive thematic approach by two independent researchers.
Results: Twenty-four proposed PC-QIs were developed. Refinement to descriptors of the proposed PC-QIs were made by the consumer group (n = 18) and all were affirmed as being amenable to change by aged care assessors. Barriers in meeting the intent of the proposed PC-QIs were identified across five domains including: health care staff knowledge (18.7%; n = 3); clear communication (31%; n = 5); person-centred approach (18.7%; n = 3); respect for client (18.7%; n = 3); and collaborative partnership with client (12%; n = 2). Participants made 21 recommendations. Of the five service elements in delivering an aged care assessment service, barriers in meeting the intent of the proposed PC-QIs were identified at the intake and booking of an assessment and during the assessment.
Conclusions: Recommendations identified provide assessment services guidance on ways to adapt service elements to better align with older adults' perceptions of quality.
Patient and Public Contribution: Patients and carers were involved as collaborators in this project at the protocol stage which included participating in discussions regarding the refining and modification of the protocol, refinement of the proposed PC-QIs, data collection forms and supplementary information for participants.
(© 2024 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Health Soc Care Community. 2022 Nov;30(6):e3593-e3628. (PMID: 36083293)
Health Expect. 2018 Apr;21(2):429-440. (PMID: 29151269)
BMC Health Serv Res. 2020 Dec 8;20(1):1131. (PMID: 33292194)
Aust N Z J Public Health. 2014 Aug;38(4):355-61. (PMID: 25091076)
BMC Geriatr. 2013 Nov 19;13:127. (PMID: 24245920)
Health Soc Care Community. 2013 Mar;21(2):171-80. (PMID: 23095078)
Fam Pract Manag. 2006 Sep;13(8):73-8. (PMID: 17022433)
J Gerontol Soc Work. 2015;58(5):503-20. (PMID: 26016493)
BMC Med Inform Decis Mak. 2016 Apr 21;16:45. (PMID: 27098100)
Acad Med. 2014 Sep;89(9):1245-51. (PMID: 24979285)
Health Sci Rep. 2019 Nov 04;2(12):e140. (PMID: 31890898)
Perspect Psychol Sci. 2012 Jul;7(4):325-40. (PMID: 26168470)
Australas J Ageing. 2019 Sep;38 Suppl 2:83-89. (PMID: 31496058)
Int Psychogeriatr. 2014 Nov;26(11):1849-62. (PMID: 25022286)

None

Keywords: administration; assessment services; older adults; person‐centred; policy; quality indicators

Date Created: 20240805 Date Completed: 20240805 Latest Revision: 20240807

20240807

PMC10768856

10.1111/hex.13958

39102731