Data Quality of National Quality Indicators in Long-term Care Facilities: a Validation and Evaluation Study

NCT06160024 | Active Not Recruiting

• 1 other identifier: WP 1.4_1.9
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 3

Brief Summary

This multiple-methods study with two data collection points (T0 and T1) aims to:

1. 1.assess inter-rater reliability of the six national quality indicators in long-term care facilities (LTCFs) for older people in Switzerland (T0);
2. 2.explore determinants of data quality of the national quality indicators (T0),
3. 3.evaluate adoption and effectiveness of a bundle of measures to improve data quality of the national quality indicators (T1).

Conditions

Reliability of National Quality Indicator Data

Outcome Measures

Primary Outcomes (10)

• Change in the rate of agreement on the presence of malnutrition

  Agreement on weight loss of 5% or more in the last 30 days or of 10% or more in the last 180 days per resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators.

  up to 6 months at each time point

• Change in the rate of agreement on the presence of self-reported pain

  Agreement on presence of daily moderate or higher pain intensity or with non-daily very strong pain intensity in the last 7 days per assessed resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators.

  up to 6 months at each time point

• Change in the rate of agreement on the presence of observed pain

  Agreement on presence of daily moderate or higher pain intensity or non-daily very strong pain intensity in the last 7 days per assessed resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators.

  up to 6 months at each time point

• Change in the rate of agreement on the presence of trunk fixation or seating that prevents the resident from rising

  Agreement on presence of daily fixation of the trunk or with seating that prevented the resident from rising in the last 7 days per assessed resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators.

  up to 6 months at each time point

• Change in the rate of agreement on the presence of bedrails

  Agreement on presence of daily use of bedrails or other devices on all open sides of the bed that did not allow the resident to leave the bed independently in the last 7 days per assessed resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators

  up to 6 months at each time point

• Change in the rate of agreement on the presence of polypharmacy

  Agreement on presence of 9 or more active ingredients in the last 7 days per assessed resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators.

  up to 6 months at each time point

• Change in the rate of agreement on the level of cognitive impairment

  Agreement on score on the Cognitive Performance Scale per assessed resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators.

  up to 6 months at each time point

• Change in the rate of agreement on the presence of depression

  Agreement on score on the Depression Rating Scale per assessed resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators.

  up to 6 months at each time point

• Change in the rate of agreement on the assessment of life expectancy

  Agreement on life expectancy (six months or longer, less than six months or not clarified) per assessed resident between routine assessor and gold standard assessor. Primary effectiveness outcomes include all 6 quality indicators and 3 variables used for risk adjustment of quality indicators.

  up to 6 months at each time point

• Primary implementation outcome: The rates of adoption of the intervention components of the program to improve the data quality of the national quality indicators

  The program with the intervention components will be defined after the first data collection period and will include training and supporting materials

  within 8 weeks

Study Arms (1)

Long-term care facilities

OTHER

All participating facilities will be offered the same bundle of measures, with core and optional or adaptable components based on the identified needs.

Behavioral: Program to improve data quality of national quality indicators

Interventions

Program to improve data quality of national quality indicators BEHAVIORAL

Interventions will be developed based on the findings from the first data collection period. A bundle of interventions (Program to improve data quality of national quality indicators) will be offered to participating long-term care facilities to support changing behavior in data collection procedures via training and supporting material as implementation strategies with the goal to improve the data quality of the national quality indicators. The program will be tested in a separate pilot study. The second data collection period in the current study will be used to evaluate the effect of the implemented program.

Long-term care facilities

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Long-term care facilities:
• have cantonal recognition as an inpatient long-term care facility
• work with nationally recognized standardized assessment instruments (i.e., RAI-NH, BESA or Plaisir/Plex)
• have at least 30 long-term residents
• have at least two different internal staff members who are involved in the data collection for the national quality indicators
• are willing to participate in two data collections (2023 and 2025) and in between to implement a implement a package of measures to optimise the reliability of the data for the national quality indicators.

Sponsors & Collaborators

• University of Basel: lead
• University of Applied Sciences and Arts of Southern Switzerland: collaborator
• Institut et Haute Ecole de la Santé la Source: collaborator

Study Sites (3)

Institut für Pflegewissenschaft - Nursing Science (INS), University of Basel

Basel, Basel, 4056, Switzerland

Location

Institut et Haute Ecole de la Santé La Source

Lausanne, Canton of Vaud, 1004, Switzerland

Location

Scuola universitaria professionale della Svizzera italiana

Manno, Canton Ticino, 6928, Switzerland

Location

Study Officials

• Franziska Zúñiga, Prof. Dr.

  University of Basel

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: The study addresses long-term care facilities

Study Record Dates

• First Submitted: November 12, 2023
• First Posted: December 7, 2023
• Study Start: October 14, 2023
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: February 27, 2026

Record last verified: 2026-02

Locations

CH (3)