Here's a snapshot of outcomes indicators
Here’s a snapshot of outcomes indicators
Long-term care indicators were field-tested
The Maryland Hospital Association in Lutherville has been tracking outcomes for hospitals for 12 years through its Quality Indicator Project, and now it’s adding indicators for long-term facilities.
The five indicators the nonprofit association has devised for long-term care were pilot tested for two years with 67 facilities, says Nell Wood, director of marketing and communications.
The nonprofit Maryland Hospital Association started tracking outcomes for acute care facilities in 1985, growing from seven to more than 1,100 hospitals. The association will add indicators for long-term care on July 1, Wood says. "We were lucky when it came to the pilot test process because there was so much interest that we were able to put together a very representative sample of sites," she adds.
The Quality Indicator Project is one of 61 performance measurement systems under contract by the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations. Desert Hospital in Palm Springs, CA, has been involved in the Maryland project for two years, and an administrator says she envisions a seamless transition to ORYX.
Wood says the indicators were carefully chosen and worded to avoid misinterpretations. For example, if an indicator simply requested a facility record every time a patient fell and was injured, then there might be some facilities that would record a fall each time a patient was bruised. And other facilities might record a fall only if the injury resulted in a medical assessment.
"We say an injury is defined as a situation that requires medical assessment as a direct result of the fall," Wood says.
Here are the project’s five indicators specifically designed for long-term care:
1. Unplanned weight change.
Subcategories include patients with an unplanned weight gain of 5% or more of their total body weight and patients with an unplanned weight loss of 5% or more of their total body weight.
2. Pressure ulcer prevalence.
This indicator is further categorized by pressure ulcer stages I-IV.
3. Documented falls.
This indicator includes a sub-rate for falls resulting in injury and a sub-rate for patients with more than one documented fall.
4. Unplanned transfers to acute care setting.
Breakdown rates for this indicator are as follows:
• transfers within 72 hours of admission;
• transfers for infection;
• transfers for dehydration/electrolyte imbalance;
• transfers for cardiovascular decompensation;
• transfers for evaluation/treatment of a fracture;
• transfers for other medical/surgical reason.
5. Nosocomial infection incidence.
This indicator is further categorized for lower respiratory infections, symptomatic urinary tract infection (UTI), catheter-associated UTIs, and non-catheter-associated UTIs.
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