Quality management by result-oriented indicators

Towards benchmarking in residential care for older people


Flip Maas


Frédérique Hoffmann, Manfred Huber, Flip Maas, Ricardo Rodrigues


  • City University London, UK
  • E-Qalin Ltd., Austria
  • Medizinischer Dienst des Spitzenverbandes, Bund der Krankenkassen (MDS)
  • The Ministry of Work, Health and Social Affairs (MAGS) North-Rhine-Westphalia, Germany
  • University Dortmund, Germany
  • Vilans, The Netherlands

E-Qalin GmbH: Adelheid Bruckmüller, Simon Gross, Andreas Kattnigg, Kai Leichsenring, Wilfried Schlüter, Heidemarie Staflinger

Technische Universität Dortmund, Forschungsgesellschaft für Gerontologie: Eckart Schnabel

Medizinischer Dienst des Spitzenverbandes, Bund der Krankenkassen (MDS): Uwe Brucker

City University: Julienne Meyer

Vilans, Knowledge Centre for Long-Term Care: Mirella Minkman, Ruth Pel, Sabina Mak


Care homes for older people are confronted with challenges of changing expectations from residents and their families for better quality of care and adequate staffing. In the past, quality standards in residential care have been set by professionals and have largely focused on non-quality of life/care issues such as the qualifications of staff and the structural standards of premises.
In several EU Member States, both regulators and providers have recently put in place better quality management systems and methods to advance the assessment, measurement and continuous improvement of long-term care services, partially following similar approaches.


The objectives of this project were:

  • To construct an international framework of standards including a conceptual analysis for quality of life and quality of care and a set o result-oriented indicators to define, measure and assess quality in residential care for older people, based on an exchange of experiences with result-oriented indicators in selected Member States;
  • To apply and validate this framework of standards in two ways: by consensus-building and by applying the framework of standards to an existing quality management system for residential care of older people
  • To develop guidelines for key stakeholders (management, staff, residents, relatives and regulators) on how to apply the validated framework of result-oriented quality indicators with a view to benchmarking and quality improvement
  • To produce a policy brief about benefits and opportunities of result-oriented governance in Member states’ long term care systems
  • To disseminate results and cater for further application of the end products


  • Desk research of existing quality indictors and quality management systems
  • Validation through a DELPHI process of quality indicators for care homes able to be implemented across Europe


  • Preliminary list of quality indicators for care homes based on desk research
  • DELPHI validation of indicators
  • Drafting of handbook with quality indicators and information on how to collect and assess them



  • English - Measuring Progress: Indicators for care homes
  • German - Verbesserung messen: Ergebnisorientierte Qualitätsindikatoren für Alten- und Pflegeheime
  • Dutch - Het meten van vooruitgang: Indicatoren voor verpleeg- en verzorgingshuizen
  • Spanish - Midiendo el progreso: Indicadores para las residencias
  • Czech - Měření kvality: Katalog indikátorů kvality pro domovy pro seniory


European Commission, DG Employment, Social Affairs and Equal Opportunities; PROGRESS programme


05/2009 – 12/2012