Quality indicators to support implementation of the Australian Government’s Guiding Principles for Medication Management in Residential Aged Care Facilities
In November 2022, the Commonwealth of Australia (Department of Health, Disability and Ageing) published the updated Guiding Principles for Medication Management in Residential Aged Care Facilities (Guiding Principles). The Guiding Principles contain 15 principles that set out recommendations for medication management in Australian residential care facilities. Taking a systems approach, the Guiding Principles suggest that good clinical governance is an important tool to support the development, implementation and evaluation of robust medication-related processes. The Guiding Principles recommend that every residential care facility has access to a multidisciplinary medication governance committee called a Medication Advisory Committee (MAC). MACs have a key role in leveraging data to inform quality improvement activities that improve medication-related processes and promote medication safety for all residents.
Monash University and New South Wales Therapeutics Advisory Group have developed a series of quality indicators to measure the implementation of the Guiding Principles. These indicators, called the MEGA-MAC indicators, were developed as part of Monash University’s Maximising Embedded Pharmacists in AGed CAre Medication Advisory Committees (MEGA-MAC) project.
The MEGA-MAC indicator set has four indicator domains that include a total of 28 indicators. The MEGA-MAC indicators align with existing residential care auditing activities such as the Commonwealth of Australia’s National Aged Care Mandatory Quality Indicator Program (NQIP). These indicators were designed to be completed quarterly and could assist residential care facilities to:
- Demonstrate concordance with the Guiding Principles,
- Demonstrate concordance with the new Strengthened Aged Care Quality Standards,
- Identify local quality improvement activities that improve concordance to the Guiding Principles, and
- Evaluate and monitor local quality improvement activities that aim to improve concordance to the Guiding Principles.
The MEGA-MAC indicators
- Domain 1 indicator: The MAC meeting
- Domain 2 indicator: Policies, Procedures and Guidelines
- Domain 3 indicator: Admission processes
- Domain 4 indicator: Medication review processes
The purpose of the domain 1 indicator is to assess the presence of processes that promote appropriate governance of medicine-related activities in residential care facilities.
The domain 1 indicator includes a suite of resources to support their use. These resources are:
- Indicator specification document that provides key definitions for each indicator, and
- Data collection tool that supports data collection and provides a visualisation of the residential care facility’s progress over time.
The purpose of the domain 2 indicator is to assess the availability of up-to-date policies, procedures and guidelines for medicines management in residential care facilities.
The domain 2 indicator includes a suite of resources to support their use. These resources are:
- Indicator specification documents that provide key definitions for each indicator, and
- Data collection tool that supports data collection and provides a visualisation of the residential care facility’s progress over time.
The purpose of the domain 3 indicator is to assess the presence of processes that promote quality use of medicine for newly admitted residents to residential care facilities. The domain 3 indicator includes a suite of resources to support their use. These resources are:
- Indicator specification documents that provide key definitions for each indicator, and
- Data collection tool that supports data collection and provides a visualisation of the residential care facility’s progress over time.
The purpose of the domain 4 indicator is to assess the provision of comprehensive medication review processes that promote quality use of medicines in all residents including those at high risk of medication harm. The domain 4 indicator includes a suite of resources to support their use. These resources are:
- Indicator specification documents that provide key definitions for each indicator, and
- Data collection tool that supports data collection and provides a visualisation of the residential care facility’s progress over time.
Contact for more information
For all enquiries about the MEGA-MAC indicators, please contact Monash University (Amanda.Cross@monash.edu) and NSW TAG (nswtag@stvincents.com.au).
Suggested citation
Monash University and NSW Therapeutics Advisory Group. Medication Management Indicators for Residential Aged Care Homes, 2025. Monash University and NSW TAG, Australia.
Copyright
The MEGA-MAC indicators and accompanying data collection tools are an output of the Monash University-led MEGA-MAC project and are freely available for use under the Creative Commons Licence: Non Commercial CC BY-NC-ND.
Acknowledgements
We would like to thank the MEGA-MAC QI Expert Steering Group, MEGA-MAC Pharmacists and Nursing Quality Indicator Feasibility Advisory Group, MEGA-MAC Chief Investigators and MEGA-MAC project partners.
Funding
The MEGA-MAC project is funded by the Commonwealth of Australia’s 2022 Medical Research Future Fund (MRFF) Quality, Safety and Effectiveness of Medicine Use by Pharmacists grant.