An important area of inquiry in quality measurement when using quality indicators (QIs) lies in determining what thresholds indicate good and poor resident outcomes. In July 1996, a cross-section of 13 clinical care personnel from nursing homes participated on an expert panel for threshold setting of Qls derived from Minimum Data Set (MDS) assessment data. Panel members met as a group for a day, individually determined good and poor threshold scores for each QI, reviewed statewide distributions of MDS Qls, and completed a follow-up Delphi round of the final results. Reports of MDS scores that are sent to a group of nursing homes in Missouri now include thresholds established for good and poor scores so the facilities can easily see where they are performing well and where they need to concentrate quality improvement efforts. This article describes the efforts made to develop and disseminate the thresholds for MDS scores.

Rantz, M. J., Petroski, G.F., Madsen, R.W., Scott, J., Mehr, D., Popejoy, L., Hicks, L., Porter, R., Zwygart-Stauffacher, M., & Grando, V. (1997). Setting thresholds for MDS quality indicators for nursing home quality improvement reportsJoint Commission Journal on Quality Improvement, 23(11), 602-611.