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Structuring Quality Improvement Benchmark Data in Assisted Living

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Primary Author:</td>
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Edmond Ramly, PhD</td>
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Co-Principal Investigators/Collaborators:</td>
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<p>Emma Brown, Alexandria Freitag, Zech Gerdin, Rebecca Hollett, Nicolette Johnson, Aditi Nandyal, Kristin Roskopf, Alexander Schulz, Travis Steger</p>
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Organization:</td>
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University of Wisconsin-Madison</td>
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Abstract</h2>
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Purpose</h3>
<p>This study involved the analysis of text responses to 7 open-ended questions in the 4th quarter of 2013. The aim of the analysis was to inform future development of targeted multiple choice questions to collect better benchmark data, by identifying key elements of QI structures and processes.</p>
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Background</h3>
<p>Unlike hospitals and nursing homes, assisted living facilities lack systematic quality improvement structures, and processes. This gap is being addressed by the Wisconsin Coalition for Collaborative Excellence in Assisted Living (WCCEAL), a statewide public-private network of facilities committed to implementing state-approved quality improvement programs, and sharing benchmark data. The benchmark data was collected quarterly in 2013 using a fixed set of multiple choice and open-ended questions, resulting in quantitative and text data respectively.</p>
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Materials &amp; Methods</h3>
<p>Responses from the 274 WCCEAL facilities (out of 3444 in Wisconsin) were then analyzed one question at a time by inductively and iteratively coding the responses. A conceptual framework based on the Quality Triangle (define, measure, improve) was then created to organize the resulting codes and the number of mentions associated with each, as well as whether type, frequency, and participants were mentioned in associated responses. All analysis results were reviewed by the WCCEAL advisory board of experts.&nbsp;</p>
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Results</h3>
<p>The 1918 responses by the 274 facilities to the 7 questions amounted to 381137 characters of text. A total of 222 codes were identified. Deliverables included, histograms, pie charts, and tables, as well as a detailed conceptual framework synthesizing the results, and 53 new candidate quantitative survey questions.</p>
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Conclusion</h3>
<p>The current state of quality improvement in assisted living facilities reflects a diversity of structures and processes to define, measure, and improve quality and of terminologies to describe them. This analysis contributed a quantified conceptual framework and structured recommendations for quantitative benchmarking data collection. Better QI data collection systems will benefit insurance companies, regulators, facilities, and consumers.</p>
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<strong>Bibliography</strong></h3>
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Improving the Quality of Long-Term Care with Better Information, Vincent Mor, Ph.D., Milbank Quarterly September 2005 83 (3): 333&ndash;64</li>
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Improving the Quality of Long-Term Care with Better Information - The Commonwealth Fund. (n.d.). Improving the Quality of Long-Term Care with Better Information - The Commonwealth Fund. Retrieved May 15, 2014, from http://www.commonwealthfund.org/Publications/In-the-Literature/2005/Nov/...
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Wisconsin Coalition for Collaborative Excellence in Assisted Living (WCCEAL). (n.d.). WCCEAL. Retrieved May 15, 2014, from https://wcceal.chsra.wisc.edu</li>
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Zimmerman, D. R. Using Indicators To Structure Quality Improvement Initiatives in Long-Term Care. Quality Management In Health Care, 54-76.</li>
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<p>&copy; Improvement Science Research Network, 2012</p>
<p>The ISRN&nbsp;published this as received and with permission from the author(s).</p>

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