Development and pilot testing of quality improvement indicators for integrated primary dementia care

BMJ Open Quality

article

Dorien L Oostra¹  Minke S Nieuwboer²  Marcel G M Olde Rikkert²  Marieke Perry² 

[1] Department of Geriatric Medicine , Radboud university medical center, Radboud Institute for Health Sciences;Department of Geriatric Medicine , Radboud university medical center, Radboudumc Alzheimer Centre;Department of Geriatric Medicine , Radboud university medical center, Donders Institute for Brain Cognition and Behaviour;Department of Primary and Community Care , Radboud university medical center, Donders Institute for Brain Cognition and Behaviour

关键词: healthcare quality improvement;    primary care;    transitions in care;    quality measurement;    patient-centred care;   

DOI  :  10.1136/bmjoq-2020-000916

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Background Implementation of integrated primary care is considered an important strategy to overcome fragmentation and improve quality of dementia care. However, current quality indicator (QI) sets, to assess and improve quality of care, do not address the interprofessional context. The aim of this research was to construct a feasible and content-wise valid minimum dataset (MDS) to measure the quality of integrated primary dementia care.Methods A modified Delphi method in four rounds was performed. Stakeholders (n=15) (1) developed a preliminary QI set and (2) assessed relevance and feasibility of QIs via a survey (n=84); thereafter, (3) results were discussed for content validity during a stakeholder and (4) expert consensus meeting (n=8 and n=7, respectively). The stakeholders were professionals, informal caregivers, and care organisation managers or policy officers; the experts were professionals and researchers. The final set was pilot-tested for feasibility by multidisciplinary dementia care networks.Results The preliminary set consisted of 40 QIs. In the survey, mean scores for relevance ranged from 5.8 (SD=2.7) to 8.5 (SD=0.7) on a 9-point Likert scale, and 25% of all QIs were considered feasible to collect. Consensus panels reduced the set to 15 QIs to be used for pilot testing: 5 quality of care, 3 well-being, 4 network-based care, and 3 cost-efficiency QIs. During pilot testing, all QIs were fully completed, except for well-being QIs.Conclusion A valid and feasible MDS of QIs for primary dementia care was developed, containing innovative QIs on well-being, network-based care and cost-efficiency, in addition to quality of care QIs. Application of the MDS may contribute to development and implementation of integrated care service delivery for primary dementia care.

【 授权许可】

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