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The average life expectancy and the proportion of the elderly in the Western countries are increasing. The care processes used for the elderly are known to differ between the care providers in Sweden. Accordingly, the need to develop a system to support the processes in order to attain a standardized, structured, and systematic approach to improve preventive care processes for the elderly has been called for. The County Council of Jönköping developed a national Web-based quality registry, Senior Alert, with a focus on the following areas: falls, pressure ulcers, malnutrition, and oral health. The patients are evaluated using validated risk assessment instruments, and the care is planned, executed, evaluated. The registry supports the users to work with preventive care systematically and in a standardized way and provides feedback to the care providers on their preventive care processes. The registry helps the caregivers fulfill the preventive care according to the best available clinical knowledge and practice. The registry also provides the government and health care politicians with data for setting aims for elderly care. The registry is used in 90% of the municipalities and county councils throughout the country. The total number of risk assessments completed from 2009 to 2014 exceeded 1 000 000.

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Background: The proportion of elderly in the population in Sweden is increasing. Older adults are more vulnerable to disease and disability which in turn increases the prevalence of negative events as pressure ulcers, malnutrition, falls, and oral health problems. Methods: By using Senior Alert (SA), a quality registry for care prevention, analyze data concerning risks and adverse events and show the potential of the register for quality improvement and research in nursing homes and hospitals. Results: There are differences in the prevalence of pressure ulcers and weight loss in nursing homes compared to hospitals, explained by different risk scores in the assessment tools used as well as differences in the populations with regard to age and days to follow-up. Falls are more prevalent in nursing homes. Fall prevalence decreases more with higher pressure ulcer risk due to factors such as degree of mobility; the fall prevalence decreases for even higher pressure ulcer risk. Conclusions: The team around the older person needs a more inter-professional profile including healthcare such as physiotherapists, occupational therapists, dietitians, and dental health professionals. Trial registration: The study is an observational retrospective register-based study, using data from SA during 2015.