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Setting thresholds for quality indicators derived from MDS data for nursing home quality improvement reports: an
M J Rantz1, G F Petroski, R W Madsen
1Sinclair School of Nursing, University of Missouri-Columbia (MU), USA. RantzM@health.missouri.edu
The Joint Commission Journal on Quality Improvement
|February 15, 2000
Summary
Setting quality indicator (QI) thresholds for nursing home care using expert panels ensures accurate performance assessment. These updated thresholds for the Minimum Data Set (MDS) 2.0 and Resource Utilization Groups III (RUGS III) aid quality improvement initiatives.
Area of Science:
- Healthcare Quality Improvement
- Geriatric Care
- Health Services Research
Background:
- Establishing benchmarks for nursing home performance is crucial for quality improvement programs.
- Previous expert panels set thresholds for Minimum Data Set (MDS) quality indicators (QIs).
- This study updates thresholds for the revised MDS 2.0 and Resource Utilization Groups III (RUGS III) instruments.
Purpose of the Study:
- To establish updated quality indicator thresholds for nursing home care.
- To support quality improvement initiatives by providing meaningful performance benchmarks.
- To adapt thresholds to revised assessment instruments and data collection methods.
Main Methods:
- An expert panel convened to set lower (good) and upper (poor) threshold scores for each QI.
- Statewide distributions of MDS QIs were reviewed.
- A Delphi method was used for final consensus on threshold results.
Main Results:
- Thresholds were determined for the revised MDS 2.0 two-page quarterly form.
- Thresholds were established for the Resource Utilization Groups III (RUGS III) quarterly instrument.
- Quality improvement teams found the resulting QI reports helpful and easy to interpret.
Conclusions:
- Expert-driven threshold setting is repeated as needed to reflect current practices.
- Thresholds will be re-established as the MDS instrument or QI calculations evolve.
- This ensures ongoing relevance and accuracy of quality indicator benchmarks in nursing homes.
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