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Keywords:

  • quality improvement;
  • performance measures;
  • minimum data set;
  • assessment;
  • nursing homes

Abstract

Background

The quality of care provided to nursing home residents is a continuing source of concern throughout the world. In the United States, the Health Care Financing Administration mandated the use of a standardised resident assessment instrument, called the Minimum Data Set (MDS) which facilitated the development of a set of nursing home quality of care indicators.

Methods

The MDS Quality Indicators were developed by a team of researchers at the University of Wisconsin-Madison and covered 12 domains, as well as associated risk factors. This initial set of indicators then went through an iterative process of review by national clinical panels, further empirical analysis, validation studies, and pilot tests, to confirm whether they were accurate, reliable and useful tools for identifying quality problems.

Results

The final set of MDS Quality Indicators includes 24 variables that include both processes and outcomes of care and prevalence and incidence measures. They are defined at both the resident and facility level. Four of the indicators are risk-adjusted.

Conclusion

The indicators have several possible applications: a source of consumer information; to help guide policy makers; and to assist providers in conducting quality improvement initiatives and to evaluate the impact of these efforts. Copyright © 2003 John Wiley & Sons, Ltd.