|Determined an effective report format for displaying MDS QI information (MO DHSS-funded)|
Determining meaningful thresholds to reinforce excellent performance and flag potential problems areas in nursing home care is critical for preparing reports for nursing homes to use in their quality improvement programs. Simply providing feedback by comparing an individual facility's performance to statewide averages, medians, or percentile ranking may actually adversely affect care because homes may interpret their performance as superior to others because they are "better than average" and falsely assume they do not have care problems in area where they actually do have problems that need attention. If the objective is to encourage higher levels of performance, it is imperative to place high, but attainable, standards for all to achieve.
Three panels of experts have been conducted to establish thresholds for interpreting QIs. The panels were all cross-sections of well-qualified clinical care personnel from nursing homes. For each panel, members met as a group for a day, individually determined good and poor threshold scores for each QI, reviewed statewide distributions of MDS QIs and completed a follow-up Delphi of the final results. With thresholds established for interpreting good and poor scores, we used them to report MDS QI scores so homes can easily see where they are performing well and where they need to concentrate quality improvement efforts. The report format is used in the electronic longitudinal "Show-me QI Report" that are available to all homes in the state as of summer 1999.
Rantz, M.J., Petroski, G., Madsen, R., Mehr, D., Popejoy, L., Hick, L., Porter, R., Zwygart-Stauffacher, M. & Grando, V. (2000). Setting thresholds for quality indicators derived from MDS data for nursing home quality improvement reports: An update. Joint Commission Journal on Quality Improvement, 26(2): 101-110.
Rantz, M.J., Petroski, G.F., Madsen, R.W., Scott, J., Mehr, D., Popejoy, L., Hicks, L., Porter, R., Zwygart-Stauffacher, M., & Grando, V. (1997) Setting thresholds for MDS quality indicators for nursing home quality improvement reports. Joint Commission Journal on Quality Improvement, 23(11), 602-611.