Care standards are evolving globally

Quality of care has always been a focus for carers, nurses, clinicians, and industry decision-makers, but it has never been more of a critical consideration than it is today.

The introduction of new national legislation and compliance standards, together with an ageing population and growing workforce demands, is driving significant change across the aged care, home care, hospital, and disability industries in Australia, the UK, New Zealand, and beyond.

During this time, access to the right tools is crucial. PainChek®’s digital pain assessment app facilitates best-practice processes, documentation, and reporting, supporting compliance with national care standards. Find out how.

Australia’s evolving aged care quality indicators at a glance

The Royal Commission into Aged Care Quality and Safety was established in 2018 to inquire into the quality and safety of aged care in Australia. As a result, widespread legislative changes have been introduced to improve oversight and quality of care standards across the industry.

Aged Care Act
The Department of Health and Aged Care is currently building a new Aged Care Act to replace:

The new Act will be introduced to Parliament in 2024 and aims to improve the ways services are delivered to older people in their homes, community settings and approved residential aged care homes.

The new Act will also build on priority aged care reforms that have already been delivered.

Aged Care Quality Standards
The Australian Aged Care Quality Standards are eight individual standards that all government-subsidised aged care facilities need to meet, defining what good care looks like.

In response to the Royal Commission, the standards were reviewed with a final draft version of the Strengthened Aged Care Quality Standards issued in November 2023. The ‘Stronger Standards, Better Aged Care’ program is being implemented to help care providers prepare, and the existing standards remain in effect until the new standards take effect from 1 July 2024.

Supporting a restraint free environment in residential aged care
In response to findings that psychotropic medicines were being overprescribed and overused in older people, the decision-making tool “Supporting a restraint free environment in residential aged care” was released to guide the workforce and their representatives on the appropriate use of restrictive practice.

AN-ACC Funding Model
Late in 2022, the new Australian National Aged Care Classification (AN-ACC) funding model included minimum requirements for staff time with residents and mandatory quality reporting. Funding was decreased for some treatments, putting the burden on care providers to reallocate resources while optimising the quality of care.

Star Ratings for Residential Aged Care
Star Ratings for residential aged care were introduced in December 2022, to help consumers understand and easily compare the quality of care provided at aged care homes.

An overall star rating between 1 and 5 stars is provided to all facilities, across the below sub- categories:

  • Residents experience
  • Compliance
  • Staffing
  • Quality measures

The quality measures rating looks at five health conditions in residents that are important indicators of whether a home is providing high quality care to its residents.

National Aged Care Quality Indicator Program
Since July 2022 as part of the National Aged Care Mandatory Quality Program, all government-subsidised aged care homes have been required to collect data on five quality indicators:

  • Pressure injuries.
  • Physical restraint.
  • Unplanned weight loss.
  • Falls and major injury.
  • Medication management.

From April 2023, six new categories were added to the program, with providers needing to report on a further six areas of care:

  • Activities of daily living: The percentage of care recipients who experienced a decline in activities of daily living.
  • Incontinence care: The percentage of care recipients who experienced incontinence-related dermatitis.
  • Hospitalisation: The percentage of care recipients who had one or more emergency department presentations.
  • Workforce: The percentage of staff turnover.
  • Consumer experience: The percentage of care recipients who report a ‘good’ or ‘excellent’ experience of the service.
  • Quality of life: The percentage of care recipients who report ‘good’ or ‘excellent’ quality of life.

Despite the heightened focus on data collection to inform accurate and appropriate treatment, there remains a widespread lack of information sharing between systems, carers, clinicians, patients or residents, and their families.

How PainChek® supports compliance and improved care standards

PainChek®’s digital pain assessment app facilitates best-practice processes, documentation, and reporting, taking the pressure off carers, clinicians, and industry decision-makers when it comes to complying with national care standards.

The app combines PainChek®’s AI pain assessment tool, which intelligently automates the multidimensional pain assessment process, with the Numerical Rating Scale (NRS). This hybrid functionality allows objective, consistent pain assessment at the point of care for those who can self-report, those who cannot, and those whose ability fluctuates. Learn more here.

Key benefits of PainChek

  • Centralised data: All pain assessment data is stored securely and centrally in PainChek®’s detailed reporting suite, PainChek® Analytics.
  • Interoperability: PainChek® is fully interoperable with leading care management systems, enabling seamless and secure data sharing.
  • Reduced risk: No duplication of effort or the need for paper-handling reduces the risk of human error and inaccuracies.
  • Improved quality of care: PainChek® has been shown to instigate a reduction in the inappropriate use of psychotropic medication.
  • Accessibility: A fast and objective tool, PainChek® empowers staff to accurately and consistently monitor pain, saving time and costs.
  • Digital transformation: PainChek® helps facilities digitise their process and become technology leaders.
  • Ongoing support: PainChek®’s expert team is on hand to support with day-to-day and strategic decisions relating to pain assessment.
  • Reputability: PainChek® has government backing and a strong, credible reputation with clients and the industry.

Star ratings for Residential Aged Care – Looking at Quality measures

The outcomes of the five quality indicators are driving improved care delivery, with providers fostering innovation and implementing new technologies such as PainChek® to support the delivery of safe and high quality care.

Implementing PainChek® can support providers to improve care outcomes, measured against the five quality indicators:

  • Pressure injuries – Better managed pain through PainChek®’s objective and accurate pain assessment tool supports the management of pain associated with pressure injuries, and the maintenance of movement, thus reducing risk of immobility and pressure injuries.
  • Physical restraint – As an accurate, consistent, evidence based observational pain assessment, the use of PainChek® supports effective assessment, consideration, and management of pain prior to the implementation of any restrictive practices, which are an absolute last resort.
  • Unplanned weight loss – The use of PainChek® can identify instances where pain medications may no longer be required at current dosages, supporting the management of unplanned weight loss associated with side-effects.
  • Falls and major injury – Where pain is identified as a contributing factor to poor mobility or instability, PainChek® enables clinicians to assess changes in pain level pre- and post-movement; this information can then contribute to broader functional assessment, and ultimately, support person centred falls prevention strategies.
  • Medication management – PainChek® assessment results support planning of the most appropriate treatments to manage pain, which may include pharmacological or non-pharmacological measures. Appropriate management of pain in such instances may eliminate the need for the use of psychotropic agents including antipsychotics.18


REFERENCES:

1. Reddy M, Keast D, Fowler E, Sibbald RG. Pain in pressure ulcers. Ostomy Wound Manage. 2003 ;49(4 Suppl):30-5.
2. Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018 Dec 11;18(1):305. doi: 10.1186/s12877-018-0997-7.
3. Ahn H, Stechmiller J, Fillingim R, Lyon D, Garvan C. (2015), Bodily Pain Intensity in Nursing Home Residents With Pressure Ulcers: Analysis of National Minimum Data Set 3.0. Res Nurs Health 2015; 38: 207-212. https://doi.org/10.1002/nur.21654
4. Lyder CH, Ayello EA. Pressure Ulcers: A Patient Safety Issue. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 12. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2650/
5. Atee, M., et al. (2021). Pain in Dementia: Prevalence and association with neuropsychiatric behaviors. J Pain Symptom Manage. 61, 1215-1226
6. van de Rijt LJM, et al. Oral health and orofacial pain in people with dementia admitted to acute hospital wards: observational cohort study. BMC Geriatr 18, 121 (2018). https://doi.org/10.1186/s12877-018-0810-7
7. Blaum CS, Fries BE, Fiatorone MA. Factors associated with low body mass index and weight loss in nursing home residents. J Gerontol Med Sci. 1995;50A:M162–M168
8. Sampson G. Weight loss and malnutrition in the elderly. The shared role of GPs and APDS. Aust Fam Physician 2009;38:507-510. Gaddey HL. Unintentional weight loss in older adults. Am Fam Physician. 2014;89:718-722.
9. Schiffman SS. Influence of medications on taste and smell. World J Otorhinolaryngol Head Neck Surg. 2018 Mar 26;4(1):84-91. doi:
10.1016/j.wjorl.2018.02.005.
10. Leveille SG, et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009 Nov 25;302(20):2214-21.
11. Hicks C, et al. Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people. BMC Geriatr 20, 94 (2020). https://doi.org/10.1186/s12877-020-1487-2
12. Falls prevention for persons with dementia. https://www.nslhd.health.nsw.gov.au/carer/documents/NS11637A-E%20Falls%20Prevention%20for%20people%20with%20dementia.pdf
13. Achterberg W, et al. Pain in dementia. Pain Rep. 2019 Dec 25;5(1):e803. doi: 10.1097/PR9.0000000000000803.
14. ACSQHC. 6.1 Polypharmacy, 75 years and over. Australian Commission on Safety and Quality in Health Care 2021
15. Rasool MF, et al. Risk factors associated with medication errors among patients suffering from chronic disorders. Front Public Health. 2020 Nov 19;8:531038. doi: 10.3389/fpubh.2020.531038.
16. Anon. Polypharmacy. US Pharm 2017;42:13-14
17. Atee M, et al.. Pain in Dementia: Prevalence and association with neuropsychiatric behaviors. J Pain Symptom Manage 2021;61: 1215-1226.
18. Husebo BS, et al. Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial. BMJ, 2011; 343 (jul15 1): d4065 DOI: 10.1136/bmj.d4065


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I have a passion for continuous improvement in pain assessment and see the PainChek® pain assessment tool as an evolutionary development of my past work, incorporating new technologies including smart devices and artificial intelligence that further improve the pain assessment process. In particular the automated facial recognition part of the tool is impressive, and this in my view makes the pain assessment task simpler.”

– Dr Jennifer Abbey, founder of the Abbey Pain Scale

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