The National Aged Care Mandatory Quality Indicator Program (QI Program) Webinar
37:19
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Good afternoon and welcome to the qi
program webinar thank you for joining us
for many of you this won't be your first
qi program webinar
you would have tuned in when the qi
program became mandatory so welcome back
today's webinar represents yet another
milestone in the qi program journey
which will be expanded from 1 july 2021.
the qi program provides an ongoing focus
on continuous quality improvement
and improved care outcomes for senior
australians in residential care
today's webinar has been delivered by
kpmg who are assisting the department of
health in developing qi program
guidance materials for the sector before
we get started
i would like to acknowledge the
traditional owners of the lands in which
we are all meeting today
and i'd like to pay my respects to
elders past present and
emerging i would like to extend that
acknowledgement and respect to any
and any aboriginal and torres strait
islander people here today
we have a pretty tight agenda today and
lots to cover
the session will start by providing you
with an overview of the qi program
including a little bit of background
information a review of the qpqi program
objectives and a snapshot of the changes
from 1 july
you will then take a closer look at each
of the five quality indicators
then we'll look at what you need to be
prepared by one july
finally there'll be a q a session where
you will have the opportunity to ask
questions we encourage everyone to post
questions
via the blue ask a question button a
blue hand
icon as we progress through the webinar
you can submit your questions at any
time during the session
and only the facilitator will be able to
see your questions
if we don't get to answering your
question during today's session
we will be collating all questions into
a q a document
which will be distributed within a post
event email the post webinar email will
also include a link to the recording of
this session
for you to re-watch and share with your
colleagues
okay so let's make a start and dive in
today's session is about the next phase
in the qi program
journey which will see the qi program
expand to include
new quality indicators from 1 july 2021
this webinar will help you understand
the new qi program definitions and
requirements
as set out in the qi program manual 2.0
part a build your knowledge and
confidence to collect the new quality
indicators from 1 july 2021
and help us understand what information
and support
would help you prepare for the change
the qi program became mandatory for all
commonwealth subsidised residential aged
care providers
in july 2019 the quality indicators
measure important aspects of health and
wellbeing many of which can be prevented
improved or monitored more closely to
reduce adverse health events
consistent data collected according to
the qi program requirements
shows providers what is working well and
areas of care that may need improvement
and can support providers and aged care
teams to engage in continuous quality
improvement
and achieve better care outcomes
together
over time the qi program data will give
consumers
and their families information to make
more informed decisions
about the care they receive the data
will provide
insights and empower consumers with
transparent
information the qi program works on
three levels
two one provides system level data to
government and policy makers
2 give providers comparable data to
support
quality improvement and 3 empower
consumers in the community to make more
informed
decisions
from 1 july 2021 the qi
program will expand to include five
quality indicators
the changes mean all quality indicators
will have new definitions
collection and reporting requirements
there are eight categories across the
five quality indicators which specify
how each of the quality indicators are
reported
for example the quality indicator
medication management
has two categories one polypharmacy
and two antipsychotics providers and
teams will need to revise and understand
all new quality indicator definitions
and requirements
and report accurately against the
definitions and reporting requirements
outlined within the qi program manual
2.0 part a the new requirements are
shifting to enhance the quality
and type of data and to make collection
and reporting easier
the five quality indicators from 1 july
2021 will be
pressure injuries physical restraint
unplanned weight loss
falls and major injury and medication
management
from 1 july the qi program quality
indicators will be reported
as a percentage of care recipients there
have also been a range of enhancements
to make the qi program easier for
providers to collect and report data
the quality indicators have been updated
based on best practice
to provide more simple measures that are
easier to report
some key elements of the qi program
remain the same
including reporting cycles which will
still occur at the end of the quarter
via the my aged care provider portal
so the qi program from 1 july 2021
will include the following quality
indicators
the pressure injuries quality indicator
will report the percentage of care
recipients
with pressure injuries reported against
six
pressure injury stages the physical
restraint quality indicator
will report the percentage of care
recipients who are physically restrained
the unplanned weight loss quality
indicator will report across two
categories including the percentage of
care recipients who experience
significant
unplanned weight loss that is 5 or more
and the percentage of care recipients
who experience consecutive
unplanned weight loss the falls and
major injury quality indicator will
report across
two categories including the percentage
of care recipients who experience one or
more
falls and the percentage of care
recipients who experience one or more
falls
resulting in major injury
finally the medication management
quality indicator
will report across two categories
including
the percentage of care recipients who
are prescribed nine or more medications
and the percentage of care recipients
who received antipsychotic medications
before we dive in it's important to
emphasize that it is critical to read
the qi program manual 2.0
part a and engage with the guidance
material provided by the department
the first of the quality indicators is
pressure injuries
a pressure injury is a localized injury
to the skin
and or underlying tissue usually over a
bony prominence
resulting from pressure shear or
combination of both
potentially life-threatening pressure
injuries decrease
quality of life are expensive to manage
and often preventable
from one july providers will report the
percentage of care recipients with
pressure injuries
against six pressure injury stages
data collection for the pressure
injuries quality indicator
will involve one observation assessment
for each care recipient
around the same time every quarter
reporting for the pressure injuries
quality indicator will include the
number of care recipients with one or
more pressure injuries
and the number of care recipients with
one or more pressure injuries
reported against each of the pressure
injury stages
a number of details will be reported
additionally including
the total number of care recipients
assessed for pressure injuries
the number of care recipients with one
or more pressure injuries acquired
outside of the service during the
quarter the number of care recipients
with one or more pressure injuries
acquired
outside of the service during the
quarter reported against
each of the six pressure injury stages
exclusions for the pressure injuries
quality indicator
include care recipients who withheld
consent to undergo an observation
assessment for pressure injuries for the
entire quarter
and care recipients who were absent from
the service for the entire quarter
from 1 july 2021 the pressure injuries
quality indicator will report pressure
injury stages
against the icd-10 australian modified
pressure injury classification system
outlined in the prevention
and treatment of pressure ulcers slash
injuries
clinical practice guideline 2019
the second quality indicator is physical
restraint
from one july providers will report the
percentage of care recipients who are
physically restrained
data collection for the physical
restraint quality indicator
will involve a single three-day record
review for each care recipient
every quarter reporting for the physical
restraint quality indicator
will include the number of care
recipients who are physically restrained
a number of details would be reported
additionally including
the total number of care recipients
assessed for physical restraint
the number of care recipients who were
physically restrained exclusively
through the use of
a secure area and the collection date
care recipients absent from the service
for the entire three-day assessment
period
are excluded from the physical restraint
quality indicator
the quality of care principles 2014
define restrictive practices as any
practice or intervention
that has the effect of restricting the
rights or freedom of movement of a care
recipient
the qi program physical restraint
quality indicator
measures and reports data relating to
all restrictive practices
excluding chemical restraint this
includes physical restraint
mechanical restraint environmental
restraint and seclusion
as defined in the quality of care
principles
for the purposes of the qi program these
forms of restrictive practice can be
understood as follows
mechanical restraint is a practice or
intervention that is
or that involves the use of a device
to prevent restrict or subdued a care
recipient's movement for the primary
purpose
of influencing the care recipient's
behaviour
but does not include the use of a device
for therapeutic or non-behavioral
purposes
in relation to the care recipient
physical restraint is a practice or
intervention that
is or involves the use of physical force
to prevent restrict or subdued movement
of a care recipient's body
or part of a care recipient's body for
the primary purpose
of influencing the care recipient's
behavior
but does not include the use of a
hands-on technique
in a reflective way to guide or redirect
the care recipient away
from potential harm or injury if
it is consistent with what could
reasonably be considered
to be the exercise of care towards the
care recipient
environmental restraint is a practice or
intervention
that restricts or that involves
restricting
a care recipient's free access to all
parts of the care recipient's
environment
including items and activities for the
primary purpose
of influencing the care recipient's
behaviour
seclusion is a practice or intervention
that is
or that involves the solitary
confinement of a care recipient in a
room
or physical space at any hour of the day
or night where
voluntary exit is prevented or not
facilitated
or it is implied that voluntary exit is
not permitted
for the primary purpose of influencing
the care recipients behaviour
for the purposes of the qi program
restraint through the use of a secure
area includes only environmental
restraint
as defined all forms of restrictive
practice
including instances the care recipient
or their representative
instigate or request the restrictive
practice
are considered physical restraint for
the purposes of the qi
program the third quality
indicator is unplanned weight loss
unplanned weight loss
results from a deficiency in a person's
dietary
intake relative to their needs and may
be a symptom
or consequence of disease for the
purposes of the qi
program unplanned weight loss is weight
loss where there is no written strategy
or ongoing record relating to planned
weight loss for the care recipient
the two categories within this quality
indicator are significant unplanned
weight loss
and consecutive unplanned weight loss
the first category of unplanned weight
loss is significant
unplanned weight loss significant
unplanned weight loss is weight loss
equal to
or greater than five percent over a
three month period
this represents a very large amount of
body weight loss over a three month
period
and aligns to the malnutrition
diagnostic criteria
from 1 july providers will report the
percentage of care recipients who
experience significant
unplanned weight loss 5 or more
data collection for significant
unplanned weight loss will involve
collecting the weight of each care
recipient
in the last month of the quarter and
comparing it to the weight
at the last month of the previous
quarter to determine the percentage of
weight loss
weight loss taken at the end of the
quarter is known as the finishing weight
additional details to be reported
include
the total number of care recipients
assessed for significant unplanned
weight loss
while exclusions for significant
unplanned weight loss category
include care recipients who withheld
consent to be weighed
care recipients who are receiving end of
life care and care recipients who do not
have the required weight
records available here comments should
be provided
explaining why weight records were
absent
for the purposes of the qi program
unplanned weight loss
is where there is no written strategy or
ongoing record relating
to the planned weight loss for the care
recipient the second category of
unplanned weight loss is consecutive
unplanned weight loss consecutive
unplanned weight loss is weight loss of
any amount
every month over three consecutive
months
of the quarter consecutive unplanned
weight loss should not be dismissed
as a natural age related change the
detection
of consecutive unplanned weight loss
provides an early opportunity to
investigate and improve
health outcomes before they become more
significant
from one july providers will report the
percentage of care recipients
who experience consecutive unplanned
weight loss
data collection for consecutive
unplanned weight loss will involve
collecting
three monthly weights for each care
recipient every quarter
and comparing against each other as well
as the finishing weight from the
previous quarter to determine
consecutive unplanned weight loss
starting middle and finishing weights
are required for this quality indicator
details for reporting include the total
number of care recipients assessed for
consecutive
unplanned weight loss while exclusions
for the significant
unplanned weight loss category include
care recipients who withheld consent to
be weighed
at the starting middle and or finishing
weight collection dates
care recipients who are receiving
end-of-life care and care recipients
who did not have the required weight
records of previous
starting middle and or finishing weights
here
comments should be provided explaining
why the weight records
are absent for the purposes of the qi
program
unplanned weight loss is where there is
no written strategy or ongoing record
relating to planned weight loss for the
care recipient
the falls and major injury quality
indicator is a new quality
indicator to the qi program from 1 july
2021
a fallen event that results in a person
coming to rest
inadvertently on the ground or floor or
other lower level
a fall resulting in major injury is a
fall that meets
this definition and results in one or
more of the following
bone fractures joint dislocations closed
head injuries with altered consciousness
and or subdural hematoma
from 1 july providers will report the
percentage of care recipients who
experienced one or more falls
and percentage of care recipients who
experienced one or more falls resulting
in major injury
data collection for the falls and major
injury quality indicator will involve a
single review
of the care records for each care
recipient for the entire quarter
reporting for the falls and mage injury
quality indicator
will include the number of care
recipients who experienced a fall
one or more at the service during the
quarter and the number of care
recipients who receive
who experienced a full one or more at
the service resulting in major injury
or injuries during the quarter
additional details for reporting include
the total number of care recipients
assessed for falls and major injury
while exclusions for the falls and major
injury quality indicator
include care recipients who are absent
from the service for the entire quarter
medication management is the second new
qi program
quality indicator from 1 july 2021
medication management plays a critical
role in achieving quality of care for
older people
in aged care the two categories within
the medication management quality
indicator
are polypharmacy and antipsychotics
the first category of medication
management is polypharmacy
polypharmacy is defined as the
prescription of nine or more medications
to a care recipient
regular monitoring of polypharmacy is
important because
polypharmacy has been associated with
harms such as adverse drug events
cognitive decline and hospitalization
for the purposes of the qi program
medication is defined as a chemical
substance
given with the intention of preventing
diagnosing curing
controlling or alleviating disease or
otherwise enhancing
the physical and or mental welfare of
people
for the purposes of the qi program it
includes prescription
and non-prescription medicines including
complementary health care products
irrespective of the administrative route
from one july providers will report the
percentage of care recipients who are
prescribed
nine or more medications data collection
for medication management polypharmacy
will involve a single review of
medication charts
and or administration records for each
care recipient on
a selected collection date every quarter
polypharmacy reporting will include the
number of care recipients who were
prescribed nine or more medications
a number of details would be reported
additionally including the number of
care recipients assessed for
polypharmacy
and the collection date exclusions for
the medication management polypharmacy
category
include care recipients admitted to
hospital for the collection date
the second category of medication
management is antipsychotics
antipsychotics are medications
prescribed for the treatment of a
diagnosed condition of psychosis
regular monitoring of the use of
antipsychotics is important because the
inappropriate
use of certain medication classes such
as antipsychotics
has been shown to be associated with
poor health outcomes
from one july providers will report the
percentage of care recipients
who received antipsychotic medications
data collection for medication
management antipsychotics
will involve a seven day medication
chart and or
administration record review for each
care recipient
every quarter reporting for medication
management antipsychotics
will include the number of care
recipients who received an antipsychotic
medication
a number of details would be reported
additionally including
the number of care recipients assessed
for antipsychotic medications
the number of care recipients who
received an antipsychotic medication for
a diagnosed condition of psychosis
and the collection date exclusions for
the medication management
antipsychotic category include care
recipients who were admitted to hospital
for the entire
seven-day assessment period and as we
progressed through the webinar
we just like to thank everyone who's
popping questions into the chat box
we can see some really great questions
coming through
so thank you and please keep posting as
we go
okay so that concludes the deep dive of
looking specifically
at the qi program requirements
now we're going to take a second to have
a look at the data submission
requirements so
the qi program data collection cycles
have not changed and remain
in line with the financial calendar year
providers are required to collect
and report data as detailed in the qi
program manual 2.0 part a in accordance
with legislation
providers are required to submit data no
later than the 21st day of the month
after the end of each quarter it is also
worth noting that should third party
providers be used
the provider remains responsible for the
submitting of data
accurately and on time
excellent now we're going to move on to
the how to get prepared
so we have outlined and identified a
number of key steps to support you in
preparing for the one july
2021 requirements many of these steps
are based on the critical
areas of being familiar with the qi
program requirements
and the qi program manual and commuting
communicating these with your teams and
organizations as a whole
firstly it's critical to familiarize
yourself with the qi program
requirements
as detailed in the qi program manual
read and engage with the full range of
guidance materials
and understand exactly what the changes
are and what your responsibilities are
to
action change the next important step is
to identify actions required
some actions might include updating all
processes and policies
allocating qi program training time
allocating completion dates for the
training
adopting and using education and
communications
materials provided by the department
having discussions with your team is the
next step in preparation you'll need to
encourage your team to adopt and
understand the new requirements
talk to them about the changes and what
it means for your operating environment
communicate with your teams regularly
and check in with those responsible
for particular tasks establish a
collective responsibility
all staff members play an important role
in the successful
implementation and adherence to qi
program
changes finally
make a change plan to be ready on one
july
we recommend following a clear and
effective change plan
for the kind of compliance change the qi
program is looking for
we would recommend following a
behavioural change management
methodology
to provide structure this means
following a path of
making a clear goal identifying owners
and responsibility relating to the
change supporting staff to understand
and prepare for the change
equipping staff to meet the new
requirements
and putting the processes in place that
will sustain the change
over time to achieve optimal outcomes
and you can see an example of the steps
for this
change strategy on the screen which is
make it clear
make it known make it real make it
happen and make it stick
that covers the content component of
today's webinar
so we're now going to progress to the
question and answer
session thank you to everyone who's been
sending questions over during the
webinar
it's great to have such an engaged group
we're now going to be working through as
many of the questions as we can
in the remaining time we have and
remember
if we don't get to your question today
we will be answering all questions
in a q a document that will be sent to
you
post webinar via email and incorporated
into a frequently asked
questions document on the department's
website
okay so the first question that we've
got coming through
is we've been using our own templates to
collect
qi data can we keep using them
so that's a really great question thanks
for sending that one through
many organizations have developed and
introduced their own
qi data collection templates which is
fantastic
from 1 july you can keep using your own
templates
but you will need to ensure that they
are consistent
with the updated definitions and
instructions in the qi program manual
all right the next question we've got
coming through is if a resident
is prescribed antipsychotics do i need
to record this against both medication
management categories
another really great question so thanks
for that one
if a care recipient is prescribed an
antipsychotic medication
whether it be for the treatment of a
diagnosed condition of psychosis or not
then the medication would be included in
the count of medications for both
polypharmacy as well as the
antipsychotics
quality indicator categories a list of
antipsychotics will be provided
in part b of the qi program manual
which is due for publication in june
so again thanks for that question the
next one we have
is what do we do if a care recipient
refuses an
assessment for example a skin
assessment or a weight assessment to
take place
the answer to that is where a care
recipient does not provide consent for
an assessment to take place
you will need to record this under the
relevant exclusion criteria
you should not include the care
recipient in a number
assessed or counts for that quality
indicator
again thanks so much for the question
another one that we have coming through
is are respite care recipients
included in qi program
reporting and the answer to that
is yes respite care recipients
should be included in qi data collection
if they are residing at the service
during the assessment period
and do not meet exclusion criteria
okay so the next question we have is
are exclusions counted in the number of
care recipients assessed
and the answer that is no if a care
recipient
meets exclusion criteria they should not
be counted in the number of care
recipients assessed
or reported against a quality indicator
however services should ensure that the
care recipient is reported
against the relevant exclusion criteria
for example if a care recipient is
hospitalized for the entire quarter
it's logical that they are not assessed
or reported against a quality indicator
however you would report this care
recipient in the number
excluded due to hospitalization
so thanks for that question um
that is a good one to clarify okay so
another one we have coming through
is if someone is eligible for multiple
exclusions
how do we record this and uh the answer
that would be
where multiple exclusion reasons apply
to
any care recipient who is excluded from
being assessed
for a quality indicator the care
recipient should be recorded only once
against the primary reason for exclusion
uh fabulous so we've got some really
good
questions coming through another one um
are palliative care recipients excluded
so the answer that is palliative care
recipients
must be included in all qi data
collection
care recipients receiving end-of-life
care and not included in the unplanned
weight loss
data collection instead reported against
exclusion criteria so please note that
the qi
program defines end of life care as the
terminal phase of life
where death is imminent and likely to
occur within three months
sometimes this is referred to as active
dying
okay so i think we've got time for one
more question that's come through
and that is what are the collection
dates for audits
the answer that is the qi program does
not
specify collection dates for each
quality indicator
each quality indicator has specified
data collection requirements
which providers choose their own
collection dates
so providing that they are the same for
all care recipients at the service
so thanks again for all the questions
that have come through
as we said if your question didn't get
answered today
we are collating them into a q a
document
which will be circulated via a post
webinar email
okay so now we're going to move on to
a bit about the key support documents uh
that are out there for providers so
the department will publish a range of
guidance materials to support you
in meeting the requirements of the qi
program
each document serves a different purpose
and we recommend engaging with them and
encouraging staff
and where possible care recipients to do
the same too
updates and the latest material
available will be published
via the department's aged care sector
newsletter
so the key support documents include
the qi program manual 2.0
part a and part b in accordance with
legislation
providers must collect consistently and
according to part a
of the qi program manual which contains
detail about collecting
recording submitting and interpreting
information
part b the qi program manual will
provide a collection
of the best practice tools to support
providers to engage in continuous
quality improvement part a is available
now
and part b of the manual is to be
published in june
2021 okay then we have data reporting
templates
and the data reporting templates that we
used as part of the quality indicator
pilot
are being updated for the qi program
providing a simple tool to guide data
collection and reporting requirements
so these downloadable templates
automatically
calculate and summarize data for
submission
to the provider portal and will be
published for each quality indicator
then we have the qi programs quick
reference guides which provide
concise advice on each of the quality
indicators
including definitions on how provider
staff and clinical teams should assess
and record information there are also
four easy to understand information
sheets with more
general information about the qi program
for consumers and families clinical care
teams
senior staff and boards as well as gps
and allied health
a collection of the qi program
frequently asked questions or the q
a will be published as a faq document
the faqs will include all webinar
questions
the online training and education model
modules
are a highly visual quick and simple
pocket expert
approach to online learning which are a
clear and enjoyable way for provider
staff to learn about the qi
program it's reporting requirements and
using quality indicator data for
continuous quality improvement
for qr program assistance contact the my
age
care provider and assessor helpline on
1-800-836-799
this helpline will be available between
8 a.m
and 8 p.m monday to friday and between
10 a.m
and 2 p.m on saturdays then we also have
the
aged care sector newsletter updates so
for regular updates and information on
the qy program
this will be published on the
department's website and will
often be communicated via the aged care
sector newsletter
and through the department's bulk
information distribution service
which is known as bids
okay excellent now we're going to move
on to
uh two questions where we'd love to hear
back from
you so the two questions that we have
posed to better understand provider
readiness
that we would like you to answer is
one what extra tools or information
would help you prepare for the qi
program expansion from 1 july 2021
and what key tools or information
would help your organization engage in
continuous
quality improvement so just answer these
as you have been shooting your questions
through during the session
via the blue ask a question button or
blue hand
icon so just pop your responses in to
the chat
using the blue hand icon
and we'll leave five minutes for that
thanks very much
okay so thanks very much for popping
your responses to those questions into
the chat that's great
um the we're actually going to move on
to now just
wrapping up and uh just reiterating some
of the support places and where to go
for help
so just remember that the key qrqi
program documents can be accessed on the
department of health's website
and for further assistance on the qi
program this
is available by the my aged care
provider
and assessor helpline and i'll just
repeat that number again it's
1-800-836-7999
uh and as a reminder a post-event
email will be sent uh to those who
registered for the webinar for this
webinar event
and that post event email will include
the questions and
answers from today's session and as well
as a link
to the recording so you can
re-watch and share with your colleagues
thank you very much for joining us in
the qi program webinar
and we look forward to seeing you again
thanks very much bye-bye

Date published: 
26 July 2021
Video type: 
Presentation