TY - JOUR
T1 - How are regulatory oversight organisations using long-term care performance indicators
T2 - a qualitative descriptive study in 10 high-income countries
AU - Poldrugovac, Mircha
AU - Pot, Anne Margriet
AU - Klazinga, Niek
AU - Kringos, Dionne
N1 - Funding Information: MP work is funded by a Marie Skłodowska-Curie Innovative Training Network grant from the European Union. DK and NK contributed to the application for that grant. The European Union was not involved in any part of the study, including its conception, design, data collection, analysis or interpretation. Funding Information: This work was supported by the European Union's Horizon 2020 research and innovation programme within the Marie Skłodowska-Curie Innovative Training Network (HealthPros—Healthcare Performance Intelligence Professionals) under grant agreement number 765141. Publisher Copyright: © 2023 BMJ Publishing Group. All rights reserved.
PY - 2023/2/3
Y1 - 2023/2/3
N2 - OBJECTIVES: Regulatory oversight organisations play an important role in quality stewardship in long-term care (LTC) facilities. Performance indicators are a key tool for any quality-related work. Our aim was to better understand how and what performance indicators are used by regulatory oversight organisations for long-term care facilities oversight and which features are affecting their fitness for use. DESIGN: Qualitative descriptive. SETTING AND PARTICIPANTS: We explored the use of LTC facility performance indicators by 10 regulatory oversight organisations from England, Ireland, Malta, New Zealand, Norway, Scotland, Singapore, Slovenia, Sweden and the Netherlands. We collected information by means of a questionnaire, 13 follow-up interviews with 20 experts from these organisations and document review. RESULTS: Performance indicators are used by participating oversight organisations to choose priority topics for audits, prioritise facilities to be audited and to identify areas within an audited facility, that require more attention. The indicators of most interest to oversight organisations are related to the dimensions of care articulated in the preset requirements on which audits are based. When the purpose of using indicators is to design a risk assessment model, the fitness for use of indicators ultimately depends on their ability to predict non-compliances on subsequent audits. When indicators are used directly by auditors, the ease of access, clear guidance to evaluate the data and the provision of contextual information are used by oversight organisations to increase fitness for use. CONCLUSIONS: Oversight organisations do not use LTC facility performance indicators to assess quality, but rather to assess the risk of lower quality or of non-compliance with requirements. This risk-related purpose has to be considered when the indicators used in oversight are chosen and when other aspects of fitness for use, such as data analysis and displaying findings, are developed.
AB - OBJECTIVES: Regulatory oversight organisations play an important role in quality stewardship in long-term care (LTC) facilities. Performance indicators are a key tool for any quality-related work. Our aim was to better understand how and what performance indicators are used by regulatory oversight organisations for long-term care facilities oversight and which features are affecting their fitness for use. DESIGN: Qualitative descriptive. SETTING AND PARTICIPANTS: We explored the use of LTC facility performance indicators by 10 regulatory oversight organisations from England, Ireland, Malta, New Zealand, Norway, Scotland, Singapore, Slovenia, Sweden and the Netherlands. We collected information by means of a questionnaire, 13 follow-up interviews with 20 experts from these organisations and document review. RESULTS: Performance indicators are used by participating oversight organisations to choose priority topics for audits, prioritise facilities to be audited and to identify areas within an audited facility, that require more attention. The indicators of most interest to oversight organisations are related to the dimensions of care articulated in the preset requirements on which audits are based. When the purpose of using indicators is to design a risk assessment model, the fitness for use of indicators ultimately depends on their ability to predict non-compliances on subsequent audits. When indicators are used directly by auditors, the ease of access, clear guidance to evaluate the data and the provision of contextual information are used by oversight organisations to increase fitness for use. CONCLUSIONS: Oversight organisations do not use LTC facility performance indicators to assess quality, but rather to assess the risk of lower quality or of non-compliance with requirements. This risk-related purpose has to be considered when the indicators used in oversight are chosen and when other aspects of fitness for use, such as data analysis and displaying findings, are developed.
KW - AUDIT
KW - Health policy
KW - Quality in health care
KW - Risk management
UR - http://www.scopus.com/inward/record.url?scp=85147457766&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/bmjopen-2022-067495
DO - https://doi.org/10.1136/bmjopen-2022-067495
M3 - Article
C2 - 36737078
SN - 2044-6055
VL - 13
SP - e067495
JO - BMJ Open
JF - BMJ Open
IS - 2
M1 - e067495
ER -