BACKGROUND The Australian government has implemented a compulsory aged care accreditation system to guide and monitor the risk management approach in registered residential aged care (RAC) homes. This research assessed the contribution of electronic health records (EHR) to risk management in RAC homes in relation to the extent that aged care accreditation fulfils its role. METHODS A convenience sample of 5560 aged care accreditation reports published from 2011 to 2018 was manually downloaded from the Accreditation Agency web site. A mixed-method approach of text data mining and manual content analysis was used to identify any significant differences in failure to meet accreditation outcomes among the RAC homes. This took account of whether EHR or paper records were used, year of accreditation, and size and location of the homes. RESULTS It appears that aged care accreditation was focused on structure and process, with limited attention to outcome. There was a big variation between homes in their use of measurement indicators to assess accreditation outcomes. No difference was found in outcomes between RAC homes using EHR and those using paper records. Only 3% of the RAC homes were found to have failed some accreditation outcomes. Failure in monitoring mechanism was the key factor for failing many accreditation outcomes. The top five failed outcomes were Human Resource Management, Clinical Care, Information Systems, Medication Management and Behavioural Management. CONCLUSIONS Sub-optimal outcomes have limited the effectiveness of accreditation in driving and monitoring risk management for care recipient safety in RAC homes. Although EHR is an important structure and process component for RAC services, it made a limited contribution to risk management for accreditation in Australian RAC homes. Either EHR was not effective, or the accreditation process was not robust enough to recognize its influence. Aged care accreditation in Australia needs to develop further outcome-based measures that are supported by robust data infrastructure and clear guidance.

中文翻译：

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电子健康记录通过对澳大利亚养老院的认可来对风险管理做出贡献。

背景技术澳大利亚政府已经实施了强制性的老年护理认证系统，以指导和监视注册的住宅老年护理（RAC）房屋中的风险管理方法。这项研究评估了电子健康记录（EHR）对RAC家庭中风险管理的贡献，这与老年护理认证履行其职责的程度有关。方法从认可机构网站手动下载2011年至2018年发布的5560份老年护理认可报告的便利样本。文本数据挖掘和手动内容分析的混合方法用于确定RAC家庭之间未能满足认证结果的任何重大差异。这考虑到是否使用了EHR或纸质记录，认证年份以及房屋的大小和位置。结果看来，老年护理认证的重点是结构和过程，而对结果的关注有限。房屋使用评估指标评估认证结果之间存在很大差异。使用EHR的RAC房屋与使用纸质记录的房屋之间的结果无差异。发现只有3％的RAC房屋未通过某些认证结果。监测机制的失败是导致许多认证结果失败的关键因素。失败的前五名是人力资源管理，临床护理，信息系统，药物管理和行为管理。结论次优结果限制了在驱动和监控RAC家庭中受护理者安全的风险管理中进行认证的有效性。尽管EHR是RAC服务的重要结构和流程组件，但它对澳大利亚RAC家庭认证的风险管理贡献有限。电子病历不是很有效，或者认证过程不够强大，无法识别其影响。澳大利亚的老年护理认证需要制定进一步的基于结果的措施，并要有强大的数据基础架构和明确的指导。