Measuring quality of care in clinical settings

A Flinders University project is focused on improving the quality of care for older Australians in hospital.

Led by Matthew Flinders Professor Julie Ratcliffe, Professor of Health Economics in Flinders’ Caring Futures Institute, the ‘New health economic tools for improving the health and wellbeing of older Australians’ project will create tools to measure the quality of care that older people receive in clinical settings, including hospitals.

“Quality improvement efforts within the healthcare system are urgently needed, especially for older people, and yet their voices are rarely heard,” Ratcliffe said.

“This is largely because we do not have tailored tools for routine system-wide monitoring and reporting of older people’s care experience and quality of life.

“As Australia’s population continues to age, and the percentage of older people in our hospitals continues to grow, we need to ensure their needs are being met in our increasingly pressured hospital system.”

Funded by almost $3 million from the National Health and Medical Research Council’s Investigator Grant Scheme, Ratcliffe and her team will:

• develop, validate and implement preference-based Quality of Life and Quality of Care experience measures for clinical care;
• generate new evidence-based guidance to reduce an over-reliance on proxy assessors and ensure that older people with cognitive impairment and dementia are empowered to self-assess their own Quality of Life and Quality of Care experience wherever possible;
• apply the newly developed economic evaluation methods to a series of clinical interventions/new models of care targeting older people.
   

The project further develops Ratcliffe’s Quality of life — Aged Care Consumers (QOL-ACC) and Quality of Care Experience — Aged Care Consumers (QCE-ACC) measurement tools, which were rolled out nationally across the aged care system in 2023, following recommendations from the Royal Commission into Aged Care Quality and Safety.

“This rollout has meant for the first time in the history of Australia’s aged care system, the voices of more than 240,000 residents from over 2700 facilities are now being directly used for informing quality assessment processes and quality improvement in aged care,” Ratcliffe said.

“Leveraging and adapting these existing platforms, we want to further develop and validate new preference-based Quality of Life and Quality of Care experience measures, especially in areas that have the potential to maximise quality of life, including transition care and rehabilitation.

“The new tools will be implemented in a healthcare system that at the moment has a poor track record in listening to the voices of older people. Including older people in the development of these tools will empower older patients to drive quality improvements [and] influence health policy and decision-making to positively impact their health and wellbeing.”

Image credit: iStock.com/Chris Ryan