CareTrack Aged
Landmark research into the level of appropriate care provided to people in Australia's residential aged care facilities.
Project Members - Macquarie University
Professor Peter Hibbert - Program Manager
Project members - external
Professor Ian Cameron, University of Sydney
Professor Alison Kitson, University of Adelaide
Professor Richard Reed, Flinders University of South Australia
Professor Len Gray, University of Queensland
Dr Louise Wiles, Visiting Fellow, Macquarie University
Project main description
With Australia’s population ageing rapidly, the number of people aged over 85 is projected to double in the next 25 years. Our current aged care system needs to keep up with future demands and be positioned to maintain quality care. Older people in residential aged care facilities are the sickest and frailest cohort of any age group and have the highest rates of disability.
CareTrack Aged will for the first time answer the question, what proportion of care encounters delivered to older Australians in residential aged care facilities (RACF) are appropriate i.e. in line with the evidence?
CareTrack Aged builds on the ground breaking research in AIHI’s earlier highly respected population-based appropriateness studies, CareTrack Australia and CareTrack Kids.
Looking specifically at RACFs, CareTrack Aged assessed whether care provided was consistent with the evidence for best clinical practice. Findings showed that most residents of aged care homes in Australia receive best practice care for continence care but not for six other common conditions including mental health, end-of-life care and urinary tract infections.
On average, residents received care in line with guidelines 53.2% of the time. Six conditions (skin integrity, end-of-life care, infection, sleep, medication, and depression) had less than 50% adherence with indicators for best care.
Trained aged care nurses reviewed records of care delivered in residential facilities between 1 March and 31 May 2021 to assess adherence with the indicators which were developed with national experts who identified 236 indicators of care drawn from the 139 clinical practice guidelines for 16 conditions or care processes.
In the paper published in BMC Medicine, researchers evaluated the care received by 294 residents across 27,585 care encounters in 25 residential aged care facilities.
The authors state that results point to the continued difficulties faced by the aged care sector including workforce shortages with medical, nursing and allied health staff. A lack of ongoing systematic monitoring of the performance of the sector also contributes to the lower rates of evidence-based care and the results provide valuable insights into specific conditions and clinical processes where improvements should be targeted.
CareTrack Aged is a 4 year project funded by the National Health and Medical Research Council.
Publications
Hibbert PD, Molloy CJ, Wiles LK, Cameron ID, Gray LC, Reed RL, Wiles LK, Westbrook J, Arnolda G, Bilton R, Ash R, Georgiou A, Kitson A, Hughes CF, Gordon SJ, Mitchell RJ, Rapport F, Estabrooks C, Alexander GL, Vincent C, Edwards A, Carson-Stevens A, Wagner C, McCormack B, Braithwaite J. The quality of care delivered to residents in long-term care in Australia: an indicator-based review of resident records (CareTrack Aged) BMC Med 22, 22 (2024). https://doi.org/10.1186/s12916-023-03224-8
Hibbert PD, Ash R, Molloy CJ, Westbrook J, Cameron ID, Carson-Stevens A, Gray LC, Reed RL, Kitson A, Braithwaite B. Unsafe care in residential settings for older adults: a content analysis of accreditation reports. International Journal for Quality in Health Care. 2023; 35 (4). mzad085. https://doi.org/10.1093/intqhc/mzad085
Hibbert PD, Molloy CJ, Wiles LK, Cameron ID, Gray LC, Reed RL, Kitson A, Georgiou A, Gordon SJ, Westbrook J, Arnolda G, Mitchell RJ, Rapport F, Estabrooks C, Alexander GL, Vincent C, Edwards A, Carson-Stevens A, Wagner C, McCormack B, Braithwaite J. Designing clinical indicators for common residential aged care conditions and processes of care: the CareTrack Aged development and validation study. International Journal for Quality in Health Care. 2022 May 9;34(2):1-9. mzac033. https://doi.org/10.1093/intqhc/mzac033
Braithwaite J, Hibbert P, Jaffe A, White L, Cowell C, Harris M, Runciman W, Hallahan AR, Wheaton G, Williams H, Murphy E, Molloy C, Wiles L, Ramanathan S, Arnolda G, Ting HP, Hooper TD, Szabo N, Wakefield JG, Hughes CF, Schmiede A, Dalton C, Dalton S, Holt J, Donaldson L, Kelley E, Lilford R, Lachman P, Muething S. The quality of health care for children in Australia. Journal of the American Medical Association. 2018; 319(11):1113-24.
Runciman WB, Hunt TD, Hannaford NA, Hibbert PD, Westbrook JI, Coiera EW, Day RO, Hindmarsh DM, McGlynn EA, Braithwaite J. CareTrack: assessing the appropriateness of health care delivery in Australia. Med J Aust. 2012;197(2):100-5
Georgiou A, Marks A, Braithwaite J, Westbrook JI. Gaps, disconnections, and discontinuities-the role of information exchange in the delivery of quality long-term care. Gerontologist. 2013;53(5):770-9.
Hooper TD, Hibbert PD, Mealing N, Wiles LK, Jaffe A, White L, Cowell CT, Harris MF, Runciman WB, Goldstein S, Hallahan AR, Wakefield JG, Murphy E, Lau A, Wheaton G, Williams HM, Hughes C, Braithwaite J. CareTrack Kids-part 2. Assessing the appropriateness of the healthcare delivered to Australian children: study protocol for a retrospective medical record review. BMJ Open. 2015;5(4):e007749.
Wiles LK, Hooper TD, Hibbert PD, White L, Mealing N, Jaffe A, Cowell CT, Harris MF, Runciman WB, Goldstein S, Hallahan AR, Wakefield JG, Murphy E, Lau A, Wheaton G, Williams HM, Hughes C, Braithwaite J. CareTrack Kids-part 1. Assessing the appropriateness of healthcare delivered to Australian children: study protocol for clinical indicator development. BMJ Open. 2015;5(4):e007748
Braithwaite J, Hibbert P, Blakely B, Plumb J, Hannaford N, Long JC, Marks D. Health system frameworks and performance indicators in eight countries: A comparative international analysis. SAGE Open Medicine. 2017;5:2050312116686516.
Project sponsors
National Health and Medical Research Council Project Grant
Related projects
Related stream of research
Patient Safety and Appropriateness of Care
Complex Systems and Implementation Science
Project status
Current
Contact
Program Director: Peter Hibbert
Email: peter.hibbert@mq.edu.au
Phone: 0414 253 461
Centres related to this project
Content owner: Australian Institute of Health Innovation Last updated: 23 Jan 2024 12:34pm