Prioritization of indicators of the quality of care provided to older adults with frailty by key stakeholders from five canadian provinces

BMC Geriatrics

Robin Urquhart¹  Anik Giguere²  Sharon E. Straus³  Pierre J. Durand⁴  Jayna M. Holroyd-Leduc⁵  Alexis Turgeon⁶  Véronique Turcotte⁷ 

[1] Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada;Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, Canada;Quebec Excellence Centre on Aging, Quebec, Canada;VITAM – Research Centre on Sustainable Health (Centre de recherche en santé durable), 2480, chemin de la Canardière, G1J 0A4, Québec, QC, Canada;Department of Medicine, University of Toronto, Toronto, Canada;Department of Social and Preventive Medicine, Université Laval, Quebec, Canada;Departments of Medicine and CHS, University of Calgary, Calgary, Canada;Population Health and Optimal Health Practices Research Unit, Division of Critical Care Medicine, CHU de Quebec – Université Laval Research Centre, Université Laval, Quebec, Canada;Quebec Excellence Centre on Aging, Quebec, Canada;

关键词: Person-centered care;    Quality improvements;    Quality indicators;    Patient outcome assessment;   

DOI  :  10.1186/s12877-022-02843-9

来源: Springer

【 摘 要 】

BackgroundTo meet the needs of older adults with frailty better, it is essential to understand which aspects of care are important from their perspective. We therefore sought to assess the importance of a set of quality indicators (QI) for monitoring outcomes in this population.MethodsIn this mixed-method study, key stakeholders completed a survey on the importance of 36 QIs, and then explained their ratings in a semi-structured interview. Stakeholders included older adults with frailty and their caregivers, healthcare providers (HCPs), and healthcare administrators or policy/decision makers (DMs). We conducted descriptive statistical analyses of quantitative variables, and deductive thematic qualitative analyses of interview transcripts.ResultsThe 42 participants (8 older adults, 18 HCPs, and 16 DMs) rated six QIs as more important: increasing the patients’ quality of life; increasing healthcare staff skills; decreasing patients’ symptoms; decreasing family caregiver burden; increasing patients’ satisfaction with care; and increasing family doctor continuity of care.ConclusionsKey stakeholders prioritized QIs that focus on outcomes targeted to patients and caregivers, whereas the current healthcare systems generally focus on processes of care. Quality improvement initiatives should therefore take better account of aspects of care that are important for older adults with frailty, such as having a chance to express their individual goals of care, receiving quality communications from HCPs, or monitoring symptoms that they might not spontaneously describe. Our results point to the need for patient-centred care that is oriented toward quality of life for older adults with frailty.

【 授权许可】

CC BY