Quality Assurance in Long-Term Care and Development of Quality Indicators in Japan

Igarashi, Ayumi; Eltaybani, Sameh; Takaoka, Manami; Noguchi‐Watanabe, Maiko; Yamamoto‐Mitani, Noriko

doi:10.1177/2333721420975320

Cited by 12 publications

(17 citation statements)

References 23 publications

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“…The development of culturally and institutionally appropriate quality QIs requires consideration of existing QIs, as demonstrated by the comparable yet context‐specific QIs‐LTC developed in the current study. For instance, the self‐rated quality of life and family's sense of security in the current study are comparable to the candidates measures for the care outcomes of personhood, well‐being, and quality of life of the common data elements of LTC developed by the Worldwide Elements to Harmonize Research in Long‐Term Care Living Environment (WE‐THRIVE) 3,4,7 . The design of the current QIs‐LTC reflects the Japanese context in several aspects.…”

Section: Discussionmentioning

confidence: 99%

“…2 In Japan, the LTC system provides regulations mainly for structural aspects, such as facility structure and staffing, whereas the evaluation of processes and outcomes is limited. 7 Care quality is the responsibility primarily of individual agencies, and actual quality assurance and improvement interventions are minimal. 8 A publicly mandated system to comprehensively measure the process and outcome of LTC in Japan has been lacking.…”

Section: Introductionmentioning

confidence: 99%

“…8 A publicly mandated system to comprehensively measure the process and outcome of LTC in Japan has been lacking. 7 In an Japanese government has launched two databases: VISIT (monitoring & eValuation for rehabIlitation ServIces for long-Term care) and CHASE (Care, HeAlth Status & Events). 9 From April 2021, the VISIT and CHASE databases were integrated into the LIFE (Long-term care Information system For Evidence) database.…”

Section: Introductionmentioning

confidence: 99%

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Toward developing care outcome quality indicators for home care for older people: A prospective cohort study in Japan

Eltaybani

Kitamura

Fukui

et al. 2023

Geriatrics Gerontology Int

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Introduction Care quality in Japan's long‐term care (LTC) agencies, including home care, is the responsibility primarily of individual agencies, and the evaluation of service processes and outcomes is minimal. Objectives To describe the development of quality indicators for LTC (QIs‐LTC) in Japan. Methods QIs‐LTC were developed through literature review and expert panel discussions and then were piloted and used in a 2‐year longitudinal survey. The survey (launched in September 2019) targeted older people receiving home care (n = 1450), their family members (n = 880), their professional home care providers (n = 577), and managers of home care agencies (n = 122). Results Across eight domains (maintaining dignity, minimizing symptoms and disease deterioration, maintaining nutritional status, maintaining bladder/bowel control, encouraging physical activities, experiencing sound sleep, maintaining serenity and contentedness, and maintaining family's well‐being), 24 care quality objectives were set with 24 outcome QIs‐LTC and 144 process QIs‐LTC. In the survey, 84.8% of clients were using home care nursing, 26.3% were living alone, and 39.5% had dementia. In the month preceding the data collection, 13.9% of clients had a new disease or worsening of an existing disease, 8.8% were hospitalized at least once, and 47.9% did not participate in activities of interest. About 20% of clients' families were unable to spend time peacefully, and 52.8% were exhausted from the client's care. Conclusions The QIs‐LTC developed in the current study are generic and client‐ and family‐centered. They encompass objective and subjective information and would facilitate standardized monitoring if adopted and comparison between LTC settings, including home care. In addition, future research directives are outlined. Geriatr Gerontol Int 2023; 23: 383–394.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Toward developing care outcome quality indicators for home care for older people: A prospective cohort study in Japan

Eltaybani

Kitamura

Fukui

et al. 2023

Geriatrics Gerontology Int

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, the LTC insurance service disclosure system has been used to identify facility-level characteristics. The system was established by the MHLW and administered by prefectural governments in accordance with the provisions of the Long-Term Care Insurance Law (20,21). The system includes information on staff members by occupation, such as physicians, nurses, dietitians, and other facility characteristics.…”

Section: Study Design and Data Sourcementioning

confidence: 99%

Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: A retrospective cohort study.

Hamasaki

Sakata²,

Jin

et al. 2023

Preprint

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Background Wide variations in facility staffing may lead to differences in care, and consequently, adverse outcomes such as hospitalizations. However, few studies focused on types of occupations. Therefore, we aimed to examine the association between a wide variety of facility staffing and potentially avoidable hospitalizations of nursing home residents in Japan.Methods In this retrospective cohort study using long-term care and medical insurance claims data in Ibaraki Prefecture from April 2018 to March 2019, we identified individuals aged 65 years and above who were newly admitted to nursing homes. In addition, facility characteristic data were obtained from the long-term care insurance service disclosure system. Subsequently, we conducted a multivariable Cox regression analysis and evaluated the association between facility staffing and potentially avoidable hospitalizations.Results A total of 2909 residents from 235 nursing homes were included. The cumulative incidence of potentially avoidable hospitalizations at 180 days was 14.2% (95% confidence interval [CI] 12.7–15.8). Facilities with full-time physicians (adjusted hazard ratio [HR]: 0.59, 95% CI: 0.37–0.94) and a higher number of dietitians (HR: 0.72, 95% CI: 0.54–0.97) were significantly associated with a lower likelihood of potentially avoidable hospitalizations. In contrast, having nurses or trained caregivers during the night shift (HR: 1.72, 95% CI: 1.25–2.36) and a higher number of care managers (HR: 1.37, 95% CI: 1.03–1.83) were significantly associated with a high probability of potentially avoidable hospitalizations.Conclusions We revealed that variations in facility staffing were associated with potentially avoidable hospitalizations. The results suggest that optimal allocation of human resources, such as dietitians and physicians, may be essential to reduce potentially avoidable hospitalizations. To provide appropriate care to nursing home residents, it is necessary to establish a system to effectively allocate limited resources. Further research is warranted on the causal relationship between staff allocation and unnecessary hospitalizations, considering the confounding factors.

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“…There is no official or recognized definition of service capability in LTCFs, but existing research on service quality and its influencing factors can provide inspiration for clarifying this topic. A large body of tools are available to evaluate the service quality of LTCFs, including outcome measurement indicators developed by different research teams ( 23 , 24 ) or nationally unified scale tools ( 25 , 26 ). Some studies define service quality as a more comprehensive concept, covering environment, resource allocation and other factors ( 27 – 29 ).…”

Section: Introductionmentioning

confidence: 99%

Identifying the Service Capability of Long-Term Care Facilities in China: An e-Delphi Study

Wen

Chen

2022

Front. Public Health

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ObjectiveThis study develops a group of service capability indicators for long-term care facilities to assess their current conditions and makes it the first step toward the improvement of service capability in China.MethodsWe constructed an initial indicator framework based on the characteristics of long-term care services and a literature review. Potential indicators were collected, and a 2-round modified web-based Delphi process was conducted by a national multidisciplinary expert panel to construct a service capability evaluation index system. The accepted competencies of indicators were established with mean scores in all three scoring criteria (importance, feasibility, and sensitivity) ≥ 4.0, consensus rate reached 70.0%, and a coefficient of variation ≤ 0.25.ResultsA new indicator framework covering 2 dimensions of inputs and activities was developed in this study. The initial 35 indicators formed an indicator pool for the Delphi questionnaire. According to the final consensus of the expert panel, the Delphi consultation resulted in an index system comprised 31 tertiary indicators across six subdimensions (i) staffing; (ii) facilities and equipment; (iii) funding; (iv) medical inspection services; (v) health management services; (vi) institutional standard management.ConclusionThis study developed a set of indicators suitable for the long-term care system in China and is expected to be applied to measure and improve the service capability of long-term care facilities. In addition, these indicators can be used for comparisons between different LTCFs and provide an evidence basis for the further development of capability assessment tools.

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Quality Assurance in Long-Term Care and Development of Quality Indicators in Japan

Cited by 12 publications

References 23 publications

Toward developing care outcome quality indicators for home care for older people: A prospective cohort study in Japan

Toward developing care outcome quality indicators for home care for older people: A prospective cohort study in Japan

Facility staffing associated with potentially avoidable hospitalizations in nursing home residents in Japan: A retrospective cohort study.

Identifying the Service Capability of Long-Term Care Facilities in China: An e-Delphi Study

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