A new report from the Center for Excellence in Assisted Living (CEAL) recommends 96 tools that assisted living communities could use to measure and improve the quality of services they provide.
CEAL is a collaborative of 11 national organizations, including LeadingAge, which is dedicated to advancing excellence in assisted living.
Measures and Instruments for Quality Improvement in Assisted Living summarizes the results of an environmental scan of quality-measurement tools that was conducted for CEAL by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.
“This report lists many promising tools for measuring quality in assisted living,” says Steve Maag, director of residential communities at LeadingAge and a CEAL board member. “We knew anecdotally that there are measures in different health care settings that could be adapted to assisted living. We just didn’t have a very good handle on what those measures were.”
Genesis of the Quality Improvement Project
CEAL decided to launch its quality-improvement project after hosting a 2-day invitational symposium exploring the “Future of Assisted Living.” The October 2014 symposium gave a variety of assisted living stakeholder groups an opportunity to discuss how the assisted living sector could remain a viable service choice within a health care environment dominated by such health reform initiatives as managed care and accountable care organizations.
Symposium participants identified the need for assisted living communities to collect and share data across settings. That data would need to assess service quality and outcomes, they said. It would also have to reflect individual preferences, goals, and psychosocial needs, as well as medical and health care needs.
“We decided that moving forward on this priority meant developing some criteria for good practice in assisted living,” says Maag. “But first we wanted to find out what kind of measurement tools were already being used in assisted living and other health care settings.”
Now that those measurement tools have been identified, CEAL plans to create a toolkit to help organizations select and use specific measurement instruments that would work best in their organizations, he says.
What Researchers Found
Researchers initially identified 254 tools and instruments currently being used to measure various areas of quality in health care settings. After conducting a critical review of those tools, researchers selected 96 tools that they recommended for use in assisted living settings. The recommended tools fall into 5 categories:
- Person-centered care (6 tools)
- Medication management (10 tools)
- Care coordination/transitions (17 tools)
- Resident/patient outcomes (35 tools)
- Workforce (28 tools)
In addition, the report calls for the development of new tools that could be used to:
- Measure resident acuity to determine staffing sufficiency
- Provide an overall measurement of quality in assisted living
Why Measure Quality?
Measurement that provides benchmarks, determines quality of care, and guides quality improvement is just as important in assisted living as in other care settings, say the authors of the CEAL report. This measurement can:
- Help staff members better understand their services and the areas where improvement is indicated
- Allow assisted living communities using similar measures to compare themselves with other settings
- Give prospective residents and their families the benchmarking information they need to make informed decisions when selecting an assisted living provider
“Measuring quality is simply a way to determine whether you are providing the kind of care that you want to provide,” says Maag. “It gives you a way to quantify what you are doing, rather than just hoping that you are doing a good job.”