Using the Resident Assessment Instrument for quality enhancement in nursing homes

Background: in some current policy discussions concerning long-term care, the emphasis has been almost solely on the costs of care. This dialogue must be replaced with a discussion of value, which emphasizes both the costs of care and quality of care. While the Resident Assessment Instrument (RAI) was originally designed as a multidimensional assessment tool aimed at improving clinical practice, it can also provide the foundation for a comprehensive data base that can be used to assess and monitor the quality of care. Aims and conclusions: using data from four sites (in Denmark, Iceland, Italy and the USA) and eight indicators of quality that could be derived from single assessments, we demonstrate how quality might be measured and compared using the RAI. Although this is for illustrative purposes only it does show how this data base can provide invaluable information to providers about the quality of care within their facilities. It can also allow consumers and purchasers to evaluate the relative performance of different providers.