National quality indicators in Swiss nursing homes: Questionnaire survey on data reliability and users’ view on the usefulness

Abstract

Background: The publication of quality indicators is used internationally to compare the quality of nursing homes and initiate quality improvement processes. From 2019 onwards, Switzerland will nationally measure and subsequently publish the results of six quality indicators on four measurement topics (use of physical restraint measures, malnutrition, polypharmacy, self-assessed and observed pain). Objective: To assess the reliability of data collection as well as the understandability and usability of the newly developed quality indicators from the perspective of healthcare providers. Material and methods: An online survey in a convenience sample from 155 Swiss nursing homes was conducted. The participants answered the items used to measure the quality indicators based on five case study examples. They assessed the understandability of the items and the usability of the indicators for internal quality improvement as well as benchmarking with other nursing homes with a 4-point agreement Likert scale. Results: A total of 303 persons from 127 nursing homes completed the survey. In 4 out of the 5 case studies the rating of more than 90% of the respondents led to a correct classification of the quality indicator. The counting of active ingredients for polypharmacy and the assessment of observed pain proved to be difficult. More than 80% of the respondents found the items understandable. The respondents agreed more with the usability of the quality indicators for internal quality improvement (78–91%) than for external benchmarking (63–79%). Conclusion: The majority of the quality indicators were correctly classified and rated as useful. For polypharmacy, an electronic support for counting the active ingredients is recommended and for the external assessment of pain the use of a validated pain intensity scale.