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

• Published in: BMJ open quality Vol. 9; no. 2; p. e000916
• Main Authors: Oostra, Dorien L, Nieuwboer, Minke S, Olde Rikkert, Marcel G M, Perry, Marieke
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-06-2020; BMJ Publishing Group
• Subjects: Caregivers; Data collection; Delivery of Health Care, Integrated - methods; Delivery of Health Care, Integrated - standards; Delivery of Health Care, Integrated - statistics & numerical data; Delphi method; Delphi Technique; Dementia; Dementia - epidemiology; Dementia - therapy; Experts; Health administration; Humans; Medical research; Patient-centered care; Pilot Projects; Primary care; Primary Health Care - methods; Primary Health Care - standards; Primary Health Care - statistics & numerical data; Quality; Quality control; Quality Improvement; Quality Indicators, Health Care - statistics & numerical data; Quality of care; Questionnaires; Research & Reporting Methodology; Stakeholders; Surveys and Questionnaires; Validity; quality measurement; transitions in care; primary care; healthcare quality improvement; patient-centred care
• ISSN: 2399-6641; 2399-6641
• DOI: 10.1136/bmjoq-2020-000916

BackgroundImplementation 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.MethodsA 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.ResultsThe 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.ConclusionA 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.