title: Clinical outcomes in residential care: setting benchmarks for quality.
abstract: OBJECTIVE
  Australian residential aged care does not have a system of quality assessment related to clinical outcomes, or comprehensive quality benchmarking. The Residential Care Quality Assessment was developed to fill this gap; and this paper discusses the process by which preliminary benchmarks representing high and low quality were developed for it.
  
  
  METHODS
  Data were collected from all residents (n = 498) of nine facilities. Numerator-denominator analysis of clinical outcomes occurred at a facility-level, with rank-ordered results circulated to an expert panel. The panel identified threshold scores to indicate excellent and questionable care quality, and refined these through Delphi process.
  
  
  RESULTS
  Clinical outcomes varied both within and between facilities; agreed thresholds for excellent and poor outcomes were finalised after three Delphi rounds.
  
  
  CONCLUSIONS
  Use of the Residential Care Quality Assessment provides a concrete means of monitoring care quality and allows benchmarking across facilities; its regular use could contribute to improved care outcomes within residential aged care in Australia.
authors.affiliation: Institute of Health & Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. m2.oreilly@qut.edu.au
authors.forename: Maria
authors.initials: M
authors.lastname: O'Reilly
authors.forename: Mary
authors.initials: M
authors.lastname: Courtney
authors.forename: Helen
authors.initials: H
authors.lastname: Edwards
authors.forename: Stacey
authors.initials: S
authors.lastname: Hassall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D019985:Benchmarking / Q000592:standards*; D003697:Delphi Technique; D005260:Female; D006299:Health Services for the Aged / Q000592:standards; D006707:Homes for the Aged / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000592:standards; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*; D012112:Residential Facilities / Q000592:standards*