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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
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Structure of the presentation Backgrounds CQI – Rehabilitation Centres Results Further developments
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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
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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)
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CQI serves seven purposes: Consumer information: (1) Individual consumers and (2) Patient organisations Purchasing information: (3) health insurers Quality information: (4) Providers and (5) the Inspectorate for Health Care Policy information: (6) Ministry of Health Scientific information for: (7) researchers
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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
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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’)
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Results (2): benchmarkscores on information scale
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Did the RC involve significant others (e.g. partner, children, family) in your treatment ? Was there shared decision making about your treatment?
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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
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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
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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 ………
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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: h.sixma@nivel.nlh.sixma@nivel.nl Internet:www.nivel.nl
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