title: Setting thresholds for quality indicators derived from MDS data for nursing home quality improvement reports: an update.
abstract: BACKGROUND
  Determining meaningful thresholds to reinforce excellent performance and flag potential problem areas in nursing home care is critical for preparing reports for nursing homes to use in their quality improvement programs. This article builds on the work of an earlier panel of experts that set thresholds for quality indicators (QIs) derived from Minimum Data Set (MDS) assessment data. Thresholds were now set for the revised MDS 2.0 two-page quarterly form and Resource Utilization Groups III (RUGS III) quarterly instrument.
  In a day-long session in October 1998, panel members individually determined lower (good) and upper (poor) threshold scores for each QI, reviewed statewide distributions of MDS QIs, and completed a follow-up Delphi of the final results.
  The QI reports compiled longitudinal data for all residents in the nursing home during each quarter and cumulatively displayed data for five quarters for each QI. A resident roster was provided to the nursing home so that the quality improvement team could identify the specific residents who developed the problems defined by each QI during the last quarter. Quality improvement teams found the reports helpful and easy to interpret.
  
  
  CONCLUSIONS
  As promised in an earlier report, to ensure that thresholds reflect current practice, research using experts in a panel to set thresholds was repeated as needed. As the MDS instrument or recommended calculations for the MDS QIs change, thresholds will be reestablished to ensure a fit with the instrument and data.
authors.affiliation: Sinclair School of Nursing, University of Missouri-Columbia (MU), USA. RantzM@health.missouri.edu
authors.forename: M J
authors.initials: MJ
authors.lastname: Rantz
authors.forename: G F
authors.initials: GF
authors.lastname: Petroski
authors.forename: R W
authors.initials: RW
authors.lastname: Madsen
authors.forename: D R
authors.initials: DR
authors.lastname: Mehr
authors.forename: L
authors.initials: L
authors.lastname: Popejoy
authors.forename: L L
authors.initials: LL
authors.lastname: Hicks
authors.forename: R
authors.initials: R
authors.lastname: Porter
authors.forename: M
authors.initials: M
authors.lastname: Zwygart-Stauffacher
authors.forename: V
authors.initials: V
authors.lastname: Grando
mesh_terms: D000203:Activities of Daily Living; D003697:Delphi Technique; D005246:Feedback; D009735:Nursing Homes / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D011795:Surveys and Questionnaires; D017749:Total Quality Management; D014481:United States