Using quality indicators to drive improvement, not just compliance

What the QI Program covers

The QI Program has been mandatory since 1 July 2019 for Commonwealth-subsidised residential aged care.

Providers report quarterly across 14 quality indicators, covering areas such as pressure injuries, restrictive practices, unplanned weight loss, falls and major injury, medication management, activities of daily living, incontinence care, hospitalisation, workforce, consumer experience and quality of life.

Three indicators were added for enrolled nursing, allied health and lifestyle officers.

QI information is intended to measure and improve service-level performance rather than identify individual residents.

QI data also contributes to the Quality Measures component of residential aged care Star Ratings.

In-home aged care does not participate in the residential QI Program in the same way, so providers operating in home care should check the Department of Health, Disability and Ageing's current requirements.

What has changed

• The strengthened Aged Care Quality Standards, seven in total, took effect on 1 November 2025 alongside the Aged Care Act 2024.
• Star Ratings now have a redesigned Compliance rating that incorporates graded assessment against the strengthened Quality Standards as well as relevant regulatory decisions.
• Residential aged care Star Ratings continue to combine four areas: Residents' Experience, Compliance, Staffing and Quality Measures.
• The Aged Care Quality and Safety Commission began assessing aged care homes against the strengthened standards from 1 November 2025, with homes progressing through the strengthened assessment framework over the transition period.
• The verified national QI report covers January to March 2026. Review multiple reporting periods rather than relying on a single quarter.

National benchmarking makes performance increasingly visible, but the real value comes from using the same data inside the organisation to identify variation, investigate causes and track whether improvement actions are working.

The result is more external visibility. The providers who benefit most use the numbers internally first.

From reporting to improvement in five steps

1. Agree definitions and ownership.

Use the current National Aged Care Quality Indicator Program Manual as the authoritative operational reference for definitions and reporting requirements. Name one owner for each indicator.

2. Check data quality.

Confirm that figures in your care system, internal reports and QI submissions match. Spot-check records, timing and completeness each quarter.

3. Look beneath the average.

Break results down by wing, shift, time of day, resident group and staffing level where appropriate and meaningful. A home-level rate can hide a hotspot.

4. Find root causes.

Use simple tools such as the five whys or a cause-and-effect diagram.

For falls, for example, review factors such as timing, footwear, medication changes, mobility aids and handover periods before choosing an action.

5. Test, measure and embed.

Try one change at a time where practical, track the relevant measure monthly rather than waiting for the quarterly submission, and assign an owner and review date.

Report the trend and the action, not only the number, to the board.

Reading the data carefully

• A rising rate can sometimes reflect changes in detection, recording or reporting, rather than a simple deterioration in care. Review context and multiple reporting periods before drawing conclusions.
• Small homes can experience large percentage movements from relatively small changes in resident numbers or events.
• Resident characteristics and service context can affect results, so comparisons should be interpreted carefully.
• The same caution applies to incident data. The number of serious incident notifications should not automatically be interpreted as the number of separate instances of harm.

Questions boards and executives can ask

• Which indicators are moving in the wrong direction, and what are we doing about each?
• Do our internal figures reconcile with what we submit?
• Which units, locations, resident cohorts or shifts sit behind the organisation-level result?
• What changed last quarter because of this data?
• Who owns each improvement action?
• How will we know whether the action worked?

Common traps

• Treating the QI Program as a submission task rather than an improvement tool
• Different numbers appearing in different internal reports
• Indicators with no clearly named owner
• Waiting until the quarterly reporting deadline before reviewing trends
• Looking only at organisation-level averages
• Chasing a Star Rating instead of focusing on the quality of care behind the measure

Quality indicators are most valuable when they are trusted, owned and reviewed regularly.

The aim should not be simply to submit the number. It should be to understand what sits behind it, determine whether action is required and measure whether that action improved the outcome.

A Free Aged Care Health Check can help identify whether your definitions, data, reporting and review routines are ready to support that approach.