The ACAQ Evolution Trish McReynolds RNRM BHlthSc External Aged Care Quality Assessor Aged Care Quali

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The ACAQ EvolutionTrish McReynolds (RN/RM
BHlthSc External Aged Care Quality Assessor)Aged
Care Quality Coordinator (Hills Mallee Southern
Aged Care Facility)Aged Care Quality Association
(Network Coordinator)
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The Journey

• July 2000 the first networking meeting held
• July 2000 the group began collecting data and
  comparing results
• July 2003 Metro group established
• February 2004 formed a not for profit
  organisation
• April 2004 Website launched
• June 2004 - metro group ceased

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The networks combined July 2004

• Rural Group (the girls from the bush)
• Metro Group (the city slickers)

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Growth of membership

• January 2001 11 high care members 7 low care
  members
• January 2002 11 high care members 8 low care
  members
• June 2003 6 high care members 8 Low care
  members, 4 ageing in place members, 9 hospital
  sites, 3 secured dementia units approx 20 metro
  members

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Current Membership

• December 2004
• 18 High care sites
• 23 Hospital sites
• 17 Ageing in place sites
• 13 Low care sites
• 7 Secured dementia units
• 3 CACPS members
• 8 Individual members
• 2 Associate members
• www.acqa.org.au/users/members

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Development

• Develop a Quality Management Program that would
  monitor compliance with the aged care
  accreditation standards
• Develop aged care specific outcome audits
  (indicators) as these were an essential part of
  the acute accreditation process
• Change in focus and culture towards aged care and
  evidence based practice

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Hidden strengths

• Program tools are developed revised by ACQA
  network
• The simplicity of audits/indicators design I
  page web based
• Implements a resident focused internal monitoring
  program
• Can monitor individual residents at risks
• Internal external benchmarking opportunities
• Results analysed collated reports returned to
  members
• The user-friendliness of the reporting format
• Recognition support within the industry -
  IFC/JBI/ACSAA
• Monitors an organisations care and services
  against the aged care accreditation
  standards/best practice

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The Program

• 6 system audits
• 4 Quality indicators falls, medication
  incidents, infection rates, skin tear
• Resident Surveys
• A Quality Networking Group 30 South Australian
  members over 72 sites and 4 interstate members
  over 10 sites, 3 associate members 3 individual
  members.
• www.acqa.org.au/member_data/timetable

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AGED CARE PROVIDERS RESPONSIBILITIES UNDER THE
AGED CARE ACT 1997

• Ensure the residential care service complies
  with the Accreditation Standards
• Undertake a process of continuous improvement
  Measured against the accreditation standards.
• Aged Care Principles 2002 Accreditation
  Principles part 3, Division 3, 3.18 page 53
• System audits are developed to monitor compliance
  against accreditation standards
• Outcome audits identify areas for continuous
  improvement

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The process

• Audits - reviews the system in place to ensure
  compliance against accreditation standards,
  relevant Australian Standards or best practice
  guidelines developed revised on a needs basis
• Indicators - identify site specific areas for
  improvements
• Suitable for any residential aged care facility
• Network group -ongoing review and development of
  the quality activity program, sharing of
  resources and information

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The model
Benchmarks are determined (Aged Care Act
1997/Best practice)
Annual Timetable developed
Data submission comparison of results
Website/network

• Tools are developed
• Audits
• Indicators
• Surveys

Performance Indicator set
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Benefits

• Participative approach involving all members
• The ability to look outside your own organisation
  to determine internal status
• Supported to implementation of evidence based
  practice
• Improve outcomes for residents
• Results for self assessments

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Tour of website

• www.acqa.org.au/

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Practical Statistics

• Data analysis exploring, organizing and
  describing data using graphs and numerical
  summaries
• Data Production producing data that can provide
  clear answers to specific questions
• Statistical Inference draw conclusions about a
  wider universe taking into account that variation
  is everywhere.
• Moore. David The Basic of Practice of Statistics
  2nd edition 1999

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ACQA program

• Data analysis exploring, organizing and
  describing data using graphs and numerical
  summaries

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Interactive bar graph
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Line graphs

• Determine if performance indicators or mean has
  been met or identifies trends

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Box Plots - outliers
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Numerical summaries
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System Audits

• Monthly reports according to timetable
• Medication
• Environmental Risks Assessment
• Client Services
• Records Management
• Lifestyle
• Privacy
• Complaints to be developed
• www.acqa.org.au/member_data/common_reports/2004

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QUALITY INDICATORS
Quality indicators are pointers that indicate
potential problem areas which need
investigating. Centre for Health Systems
Research Analysis
Continuous Improvement
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Indicators

• Falls - monthly fall rate and 4 monthly
  evaluation
• Infection Rates 3 monthly seasonal trends and
  six monthly evaluations
• Medication system audits Omission of signatures
• Alteration to skin integrity Reason Problems
  occurred

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Outcomes achieved to date

• Reduction in physical restraint use
• Fall/ risk assessment
• Review of policies to meet best practice
• Introduction of hip protectors
• Introduction of bed monitors
• Introduction of high/low beds
• Introduction of risk management
• Exploratory data analysis
• Benchmarking Quality Management System against
  ISO 9001/2000

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Future Opportunities

• JBI Utilisation Group
• Quality Improvement Projects
• Strengthen collaborative relationships
• Introduce an education program
• Research into falls
• Automate the website
• Clinical Fellowship