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: h.sixma@nivel.nl

Internet: www.nivel.nl