Antimicrobial Stewardship and the Aged Care Quality Indicator Program

Ellie Golling & Luci Rodda

With antimicrobial resistance (AMR) now recognised as a critical threat to aged care safety, it’s no surprise that antimicrobial stewardship (AMS) has become a hot topic across residential aged care services. But if you’ve been searching the National Aged Care Mandatory Quality Indicator (QI) Program for antimicrobial use metrics and come up empty - you’re not alone.

Many in the sector are under the impression that AMS is already a mandated component of the QI Program. The reality? It’s not. Yet. So why the confusion?

Here’s what’s contributing to the misunderstanding — and what you can do to prepare for what’s likely coming.

1. 📣 Consultations and Recommendations Sounded Like Policy

Back in 2022–2023, both the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the Aged Care Quality and Safety Commission (ACQSC) put forward strong recommendations to include antimicrobial use and infection outcome indicators in the QI Program.

These proposals were part of broad stakeholder consultations aimed at strengthening clinical governance and improving safety outcomes across aged care. For many, this sounded like a done deal — but in fact, no AMS-related indicators have been implemented in the mandatory QI Program to date.

As of October 2025, the only medication-related indicators included in the QI Program are:

• Poly-pharmacy (≥9 medications)

• Use of antipsychotics

While relevant to medication safety, these do not address antimicrobial use or stewardship directly.

2. 🧪 Voluntary Reporting and Pilot Programs Blur the Picture

Some aged care providers — especially those working with Primary Health Networks (PHNs) or hospital outreach AMS teams — are participating in pilot programs that track antimicrobial prescribing internally.

These programs often include:

• Tracking the number of residents on antibiotics

• Recording indications and duration

• Reviewing adherence to prescribing guidelines

Because these programs mirror what a national indicator might look like, it's easy to assume they’re part of a formal national framework. However, these are local quality improvement initiatives, not mandated national reporting requirements.

3. 📊 Clinical Indicators ≠ QI Program Indicators

Another source of confusion is the distinction between:

• Mandatory QI Program indicators (reported to the Department of Health and Aged Care), and

• Facility-level clinical indicators, which may be tracked for internal quality improvement.

Many aged care services already collect data on clinical issues like:

• Number of urinary tract infections (UTIs)

• Rate of antimicrobial prescribing

• Number of residents treated for suspected infections

These are sometimes linked to accreditation readiness, AMS audits, or infection control improvement cycles. While these activities often align with the ACSQHC’s AMS Clinical Care Standard, they remain voluntary and not part of the QI Program.

🧠 So What Does This Mean for Providers?

Although antimicrobial use isn’t (yet) part of the national QI Program, there are compelling reasons to start tracking and improving AMS practices now:

• The National AMR Strategy outlines aged care as a priority area for improved surveillance and reporting.

• AMS is embedded in the Aged Care Quality Standards, particularly around safe and effective clinical care.

• Aged care homes that track antimicrobial use will be better prepared when — not if — formal reporting becomes mandatory.

✅ What You Can Do Now

Here are some practical steps for facilities to strengthen AMS efforts ahead of national requirements:

• Implement local AMS indicators (e.g. % of residents on antibiotics, % with documented indication)

• Use ACSQHC’s AMS Clinical Care Standard as your guiding framework

• Engage GPs and pharmacists in regular audit and feedback

• Educate staff on stewardship principles and documentation expectations

• Communicate with residents and families about when antibiotics are needed — and when they’re not

🔍 Key Takeaway

The inclusion of AMS indicators in the aged care QI Program isn’t here yet — but the building blocks are being laid, and many facilities are already acting on best practice guidance.

Being ahead of the curve isn’t just about compliance — it’s about safer, smarter, more person-centred care.

📥 Want help getting started?

We’re developing practical AMS audit templates and easy-to-use dashboards for aged care teams. If you're interested in piloting a simple internal reporting tool or co-designing staff education resources, get in touch.

Let’s make stewardship standard — before it’s mandated.