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Quality of care from the patients perspective;
the CQI rehabilitation centres
Herman Sixma / NIVEL
ESCIF - 2011
De Rijp - 19 May 2011
Structure of the presentation
Backgrounds CQI – Rehabilitation Centres
Results
Further developments
What is the Consumer Quality Index® ?
CQI = National standard Based on CAHPS + QUOTE Instruments measuring: Importance,
Experiences and Overall quality; Protocols for: sampling, data
collection, analyses and reporting Registered trademark
Why asking for experiences in stead of patient satisfaction?
”Questions asking for ‘reports’ tend to reflect better the quality of care and are more interpretable and actionable for quality improvement purposes than ratings of satisfaction or excellence.”
(Cleary & Edgman-Levitan, JAMA 1997; 278: 1608-1612)
CQI serves seven purposes:
Consumer information: (1) Individual consumers and (2) Patient organisations
Purchasing information: (3) health insurersQuality information: (4) Providers and (5)
the Inspectorate for Health CarePolicy information: (6) Ministry of HealthScientific information for: (7) researchers
The development process
Preparatory phase Construction phase (desk research, fgd’s) Psychometric testing Discriminative power (MLA)
Resulting in two new CQI instruments:- CQI RC for adult patients- CQI RC for parents of children
Results (1)
Benchmark scores (between 1 – 4) on 10 - 13
QoC dimensions; scores varying between 2.9
(information) and 3.7 (courtesy, safety)
Percentages of responses on all the CQI
questions, with % negative experiences varying
between < 1% and approx. 80% (‘second
opinion’)
12
3
4
5
6 7
8
9
10
11
12
13
14
15
1617
1819
20
21
22
23
2.4
2.6
2.8
33
.2
Sch
aa
lsco
re (
gem
idd
eld
2.8
76
)
1 23Rangnummer
Informatie van het revalidatiecentrum
Results (2): benchmarkscores on information scale
26.1
33.1
24.6
22.6
49.3
44.3
0% 20% 40% 60% 80% 100%
Uw organisatie
Totale steekproef
nooit/soms
meestal
altijd
Did the RC involve significant others (e.g. partner, children, family) in your treatment ?
23.2
24.1
25.6
30.9
51.2
45.0
0% 20% 40% 60% 80% 100%
Uw organisatie
Totale steekproef
nooit/soms
meestal
altijd
Was there shared decision making about your treatment?
Most important QoC aspects according to RC patients (including spinal cord injury patients)
Professional competence Courtesy, personal attitude staff members Feeling of safety and trust Information and explanation Privacy
Possibilities QoC improvement according to spinal cord injury patients (N = 124)
Information (‘second opinion’, relevant patient organisations, time till treatment starts, complaint procedure, support after discharge) Privacy (single rooms, during visiting hours) Support significant others (parents, partner, children) Number of staff members Possibility to talk about relationships and sexuality
CQI-RC; further developments
Calibration and optimization of the instrument Modules for specific target groups Child friendly versions (8-11 and 12-15 years) Internationalization ……… ………
CQI- Rehabilitation Centres,contact details
Herman J. Sixma
NIVEL – Netherlands Institute for Health
Services Research
PO Box 1568
3500 BN Utrecht – The Netherlands
E-mail: [email protected]
Internet: www.nivel.nl