Monitoring quality of care in nursing homes and making information available for the general public: state of the art.

OBJECTIVE To improve quality of care, nursing homes need to assess and monitor their performance. This study aims to gain insight in the availability and contents of publicly accessible quality systems in northwestern Europe and the USA. METHODS This study employed a systematic search consisting of searching bibliographic sources from 2005 to September 2009, personal communication with experts, a conventional internet search, and hand-searching of references. RESULTS Ten out of the 14 included countries use a quality systems. There is a large variety in type and number of indicators assessed. In general more attention is paid to the assessment of structure and process indicators, compared to outcome indicators. The countries differ in the way the results are made available to the general public. CONCLUSION It can be concluded that monitoring and publicizing data on quality of care in nursing homes is becoming increasingly widespread. However, the systems still need further development and refinement. PRACTICE IMPLICATIONS The systems need to be further developed regarding validity and reliability. Furthermore, the uniformity of the systems should be increased, more attention must be paid to the assessment of patient satisfaction, and additional insight must be gained in the user-friendliness of the systems.