The development of quality indicators to improve psychosocial care in dementia

2012 ◽  
Vol 24 (6) ◽  
pp. 921-930 ◽  
Author(s):  
Emmelyne Vasse ◽  
Esme Moniz-Cook ◽  
Marcel Olde Rikkert ◽  
Inge Cantegreil ◽  
Kevin Charras ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Psychosocial Care ◽  
Implementation Process ◽  
Psychosocial Interventions ◽  
Dementia Care ◽  
Face Validity ◽  
Modified Delphi ◽  
Modified Delphi Technique ◽  
Multinational Strategy

ABSTRACTBackground: The evidence for the effectiveness of psychosocial interventions in dementia care is growing but the implementation of available evidence is not automatic. Our objective was to develop valid quality indicators (QIs) for psychosocial dementia care that facilitate the implementation process in various countries and settings.Methods: A RAND-modified Delphi technique was used to develop a potential set of QIs. Two multidisciplinary, international expert panels were involved in achieving content and face validity. Consensus on the final set was reached after a conference meeting where a third panel of dementia experts discussed measurability and applicability of the potential set. A retrospective cohort study was conducted to study the feasibility of using the final set in day care centers, hospitals, and nursing homes in Spain and The Netherlands.Results: A total of 104 recommendations were selected from guidelines and systematic reviews and appraised for their contribution to improving the quality of dementia care by 49 dementia experts. Twenty-five experts attended the conference meeting and reached consensus on a set of 12 QIs representing the key elements of effective psychosocial care, such as shared decision-making and interventions tailored to needs and preferences. Data from 153 patient records showed that all but one QI subitem were applicable to all three settings in both countries.Conclusion: Our multidisciplinary and multinational strategy resulted in a set of unique QIs that aims exclusively at assessing the quality of psychosocial dementia care. Following implementation, these QIs will assist dementia care professionals to individualize and tailor psychosocial interventions.

scholarly journals The Integration of Psychosocial Care into National Dementia Strategies Across Europe: Evidence from the Skills in DEmentia Care (SiDECar) Project

2021 ◽  
Vol 18 (7) ◽  
pp. 3422
Author(s):  
Ilaria Chirico ◽  
Rabih Chattat ◽  
Vladimíra Dostálová ◽  
Pavla Povolná ◽  
Iva Holmerová ◽  
...  
Keyword(s):  
Content Analysis ◽  
Clinical Practice ◽  
Social Services ◽  
Psychosocial Care ◽  
Psychosocial Interventions ◽  
System Of Care ◽  
Dementia Care ◽  
Integrated System ◽  
Health And Social Services

There is evidence supporting the use of psychosocial interventions in dementia care. Due to the role of policy in clinical practice, the present study investigates whether and how the issue of psychosocial care and interventions has been addressed in the national dementia plans and strategies across Europe. A total of 26 national documents were found. They were analyzed by content analysis to identify the main pillars associated with the topic of psychosocial care and interventions. Specifically, three categories emerged: (1) Treatment, (2) Education, and (3) Research. The first one was further divided into three subcategories: (1) Person-centred conceptual framework, (2) Psychosocial interventions, and (3) Health and social services networks. Overall, the topic of psychosocial care and interventions has been addressed in all the country policies. However, the amount of information provided differs across the documents, with only the category of ‘Treatment’ covering all of them. Furthermore, on the basis of the existing policies, how the provision of psychosocial care and interventions would be enabled, and how it would be assessed are not fully apparent yet. Findings highlight the importance of policies based on a comprehensive and well-integrated system of care, where the issue of psychosocial care and interventions is fully embedded.

scholarly journals Reporting quality of the Delphi technique in reporting guidelines: a protocol for a systematic analysis of the EQUATOR Network Library

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e024942 ◽  
Author(s):  
Masahiro Banno ◽  
Yasushi Tsujimoto ◽  
Yuki Kataoka
Keyword(s):  
Health Research ◽  
Delphi Technique ◽  
Reporting Quality ◽  
Quality Score ◽  
Reporting Guidelines ◽  
Systematic Analysis ◽  
Modified Delphi ◽  
Equator Network ◽  
Modified Delphi Technique

IntroductionReporting guidelines are important tools for improving the quality of medical research. The Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network’s Library contains a comprehensive and up-to-date database of reporting guidelines relevant to health research. Only 31% of reporting guidelines published from 2010 to 2014 reported using the Delphi technique, and the reporting quality of the Delphi technique in reporting guidelines is unknown even though the use of the Delphi technique was recommended in the guidance for reporting guidelines. We will assess the quality reports of the Delphi technique or modified Delphi technique in reporting guidelines.Methods and analysisThe present study is a systematic analysis of the EQUATOR Network Library. We will include all reporting guidelines in the EQUATOR Network that used the Delphi technique or modified Delphi technique, published since 1 January 2011 and registered in the EQUATOR on or before 31 May 2018. Our primary outcome is the reporting quality of the Delphi technique, measured by the quality score (each item) in the Delphi technique. We will also examine the relationship between the reporting quality score (each item) of the Delphi technique and year of publication, number of authors, impact factor, sources of funding (industry, non-industry), multiple publications and whether the guidelines are published in open access policy.Ethics and disseminationEthics approval will not be applicable for this study. This protocol has been registered in the University Hospital Medical Information Network Clinical Trials Registry. We will publish our findings in a peer-reviewed journal and may also present them at conferences.Trial registration numberUMIN000032685.

Psychosocial Status of Turkish Families of Pediatric Cancer Patients

2019 ◽  
Vol 31 (3) ◽  
pp. 227-241
Author(s):  
Melike Ayca Ay ◽  
Imatullah Akyar
Keyword(s):  
Cancer Patients ◽  
Pediatric Cancer ◽  
Family Members ◽  
Psychosocial Care ◽  
Psychosocial Interventions ◽  
Care Quality ◽  
Psychosocial Effects ◽  
Pediatric Cancer Patients ◽  
Sample Characteristics

Introduction: In some countries, family members are not involved in routine pediatric cancer psychosocial care although it is essential. This integrative review aims to determine the extent of research on family members of pediatric cancer patients in Turkey. Method: Four main keywords were used: parent/sibling/family, child/pediatric, cancer and psychosocial outcomes to search articles on PubMed, EKUAL, ULAKBİM, WOS databases (limited to 1997-2017). Among first 317 hits, 284 records were excluded. Of 33 eligible articles, 14 were excluded due to sample characteristics. Results: Research on psychosocial effects of pediatric cancer on family members is mostly descriptive and offers moderate-quality evidence. The reported psychosocial effects are (1) depression, anxiety, hopelessness, acceptance; (2) burden of care, quality of life, posttraumatic stress disorder; and (3) need for social support, information. Discussion: This study will contribute to the literature and help for the planning of protective psychosocial interventions for family members of children with cancer in Turkey.

scholarly journals Quality Indicators for Appropriate Outpatient Parenteral Antimicrobial Therapy in Adults: A Systematic Review and RAND-modified Delphi Procedure

2019 ◽  
Vol 70 (6) ◽  
pp. 1075-1082 ◽  
Author(s):  
Marvin A H Berrevoets ◽  
Jaap ten Oever ◽  
Anke J M Oerlemans ◽  
Bart Jan Kullberg ◽  
Marlies E Hulscher ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Indicators ◽  
Antimicrobial Therapy ◽  
Expert Panel ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Modified Delphi ◽  
Delphi Procedure ◽  
Antimicrobial Management ◽  
Patient Selection Criteria

Abstract Background Our aim in this study was to develop quality indicators (QIs) for outpatient parenteral antimicrobial therapy (OPAT) care that can be used as metrics for quality assessment and improvement. Methods A RAND-modified Delphi procedure was used to develop a set of QIs. Recommendations on appropriate OPAT care in adults were retrieved from the literature using a systematic review and translated into potential QIs. These QIs were appraised and prioritized by a multidisciplinary panel of international OPAT experts in 2 questionnaire rounds combined with a meeting between rounds. Results The procedure resulted in 33 OPAT-specific recommendations. The following QIs that describe recommended OPAT care were prioritized by the expert panel: the presence of a structured OPAT program, a formal OPAT care team, a policy on patient selection criteria, and a treatment and monitoring plan; assessment for OPAT should be performed by the OPAT team; patients and family should be informed about OPAT; there should be a mechanism in place for urgent discussion and review of emergent clinical problems, and a system in place for rapid communication; laboratory results should be delivered to physicians within 24 hours; and the OPAT team should document clinical response to antimicrobial management, document adverse events, and monitor QIs for OPAT care and make these data available. Conclusions We systematically developed a set of 33 QIs for optimal OPAT care, of which 12 were prioritized by the expert panel. These QIs can be used to assess and improve the quality of care provided by OPAT teams.

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

2020 ◽  
Vol 9 (2) ◽  
pp. e000916
Author(s):  
Dorien L Oostra ◽  
Minke S Nieuwboer ◽  
Marcel G M Olde Rikkert ◽  
Marieke Perry
Keyword(s):  
Quality Of Care ◽  
Cost Efficiency ◽  
Care Service ◽  
Well Being ◽  
Dementia Care ◽  
Improve Quality ◽  
Pilot Testing ◽  
Modified Delphi ◽  
Care Organisation

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.

scholarly journals European Society of Cardiology methodology for the development of quality indicators for the quantification of cardiovascular care and outcomes

2020 ◽  
Author(s):  
Suleman Aktaa ◽  
Gorav Batra ◽  
Lars Wallentin ◽  
Colin Baigent ◽  
David Erlinge ◽  
...  
Keyword(s):  
Quality Indicators ◽  
European Society ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Implementation Process ◽  
Feasibility Assessment ◽  
Expert Opinions ◽  
European Society Of Cardiology ◽  
Cardiovascular Care

Abstract Aims It is increasingly recognized that tools are required for assessing and benchmarking quality of care in order to improve it. The European Society of Cardiology (ESC) is developing a suite of quality indicators (QIs) to evaluate cardiovascular care and support the delivery of evidence-based care. This paper describes the methodology used for their development. Methods and results We propose a four-step process for the development of the ESC QIs. For a specific clinical area with a gap in care delivery, the QI development process includes: (i) the identification of key domains of care by constructing a conceptual framework of care; (ii) the construction of candidate QIs by conducting a systematic review of the literature; (iii) the selection of a final set of QIs by obtaining expert opinions using the modified Delphi method; and (iv) the undertaking of a feasibility assessment by evaluating different ways of defining the QI specifications for the proposed data collection source. For each of the four steps, key methodological areas need to be addressed to inform the implementation process and avoid misinterpretation of the measurement results. Conclusion Detailing the methodology for the ESC QIs construction enables healthcare providers to develop valid and feasible metrics to measure and improve the quality of cardiovascular care. As such, high-quality evidence may be translated into clinical practice and the ‘evidence-practice’ gap closed.

scholarly journals Quality indicators for Palliative Day Services: A modified Delphi study

2018 ◽  
Vol 33 (2) ◽  
pp. 197-205 ◽  
Author(s):  
Noleen K McCorry ◽  
Sean O’Connor ◽  
Kathleen Leemans ◽  
Joanna Coast ◽  
Michael Donnelly ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Indicators ◽  
Delphi Study ◽  
Service Providers ◽  
Panel Discussion ◽  
Unmet Need ◽  
Modified Delphi ◽  
Starting Point ◽  
Day Services

Background: The goal of Palliative Day Services is to provide holistic care that contributes to the quality of life of people with life-threatening illness and their families. Quality indicators provide a means by which to describe, monitor and evaluate the quality of Palliative Day Services provision and act as a starting point for quality improvement. However, currently, there are no published quality indicators for Palliative Day Services. Aim: To develop and provide the first set of quality indicators that describe and evaluate the quality of Palliative Day Services. Design and setting: A modified Delphi technique was used to combine best available research evidence derived from a systematic scoping review with multidisciplinary expert appraisal of the appropriateness and feasibility of candidate indicators. The resulting indicators were compiled into ‘toolkit’ and tested in five UK Palliative Day Service settings. Results: A panel of experts independently reviewed evidence summaries for 182 candidate indicators and provided ratings on appropriateness, followed by a panel discussion and further independent ratings of appropriateness, feasibility and necessity. This exercise resulted in the identification of 30 indicators which were used in practice testing. The final indicator set comprised 7 structural indicators, 21 process indicators and 2 outcome indicators. Conclusion: The indicators fulfil a previously unmet need among Palliative Day Service providers by delivering an appropriate and feasible means to assess, review, and communicate the quality of care, and to identify areas for quality improvement.

scholarly journals An Implementation Process Evaluation Based on an Integrated Psychosocial Support Program of Colorectal Cancer Couples in China: A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 110
Author(s):  
Jieyu Li ◽  
Xingjuan Luo ◽  
Qiuping Li
Keyword(s):  
Colorectal Cancer ◽  
Psychosocial Support ◽  
Qualitative Interviews ◽  
Psychosocial Care ◽  
Implementation Process ◽  
Psychosocial Interventions ◽  
Analysis Data ◽  
Future Research ◽  
Successful Implementation ◽  
Personal Factors

Studies have shown that the qualitative process assessment of cancer couple-based psychosocial interventions is often ignored. This article aims to evaluate the implementation process of an integrated psychosocial program developed for colorectal cancer couples. Semi-structured qualitative interviews were conducted with eight colorectal cancer couple participants and two intervention facilitators. Normalization Process Theory was used to guide the data collection and analysis. Data analysis was conducted using a directed content analysis approach within a framework approach. Participants had a good understanding of the program significance. For most participants, the intervention duration was appropriate, and was well integrated into daily life. A lack of understanding of psychological nursing, and a lack of confidence in the use of online platforms and other personal factors, inhibited participants’ experience of participating in the intervention. The facilitator’s challenge in the implementation process was being flexible in dealing with situations occurring outside of the framework plan. Face-to-face and online psychological interventions require more flexibility, and participant cognition of psychosocial care was the key to the successful implementation of the intervention. Future research should consider raising participants’ awareness of psychological care to better integrate this type of intervention into participants’ daily lives and routine care.

scholarly journals A Regional Massive Hemorrhage Protocol: Designed with a Modified Delphi Technique to Obtain Consensus

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5792-5792
Author(s):  
Jeannie Callum ◽  
Calvin Yeh ◽  
Mark McVey ◽  
Andrew Petrosoniak ◽  
Stephanie Cope ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Patient Outcomes ◽  
Research Funding ◽  
Delphi Technique ◽  
Massive Hemorrhage ◽  
Hemorrhage Control ◽  
Modified Delphi ◽  
Modified Delphi Technique ◽  
Improve Patient ◽  
Selection Of

Background: The cornerstone of a massive hemorrhage protocol (MHP) is the rapid delivery of blood components to mitigate the consequences of hemorrhagic shock, coagulopathy, and hypothermia in the exsanguinating patient pending definitive hemorrhage control. MHPs are used to facilitate protocol activation/termination, mobilize an interdisciplinary team, provide immediate access to blood, prioritize rapid blood testing, and commence hypothermia-prevention strategies. Non-randomized, before-after implementation studies have found an association between MHPs and improved patient outcomes, including mortality. There is variability in MHP implementation rates, content, and protocol compliance due to challenges presented by infrequent activation, variable team performance, and patient acuity. Methods: We used a modified Delphi technique to establish the framework for a standardized Provincial MHP toolkit and develop quality indicators. We assembled a panel of 36 content experts to represent relevant stakeholders at 150 Ontario hospitals. Panelists included physicians, nurses, and technologists from anesthesia, trauma, obstetrics, hematology, transfusion, emergency, transport, critical care, as well as representation by blood suppliers and patients. The group represented the diverse geographic healthcare program including academic, pediatric, suburban, and small rural hospitals. Panelists were required to attend a two-day MHP forum and complete all rounds of the Delphi. Panelists used digital surveys (LimeSurvey, Hamburg, Germany) to independently review 43 statements and 8 quality indicators drafted by a steering committee. Each statement was rated on a 7-point Likert scale from "definitely should not" to "definitely should include". Disposition of items was based on critieria determined a priori on the median Likert score. Round 1: (1) score at least >5.5 incorporated as written, (2) 2.6-5.4, discussed at the forum with all panelists, with a 2nd round revision, (3) <2.5, removed from further rounds, unless there was a strong opposition by the panel and a revision drafted for the second round. Novel statements and quality indicators could be added in the first round. No additional statements were added after round two. For the 2nd and 3rd rounds: (1) >5.5, accepted, (2) 2.4-5.4, rewritten and sent for round 3, (3) <2.4, removed. Merging or division of statements could occur where appropriate. Results: After 3 rounds, consensus was reached for 42 statements and 8 quality indicators. A 100% response rate was achieved from panelists in all three rounds. There were four main areas that required additional rounds and major modifications: (1) selection of the name of the protocol; (2) selection of the laboratory resuscitation targets; (3) determination of the pack configurations; and, (4) clarification of the role of rVIIa. The obstacle to selecting a unified name for the protocol was that many of the hospitals already had longstanding MHPs with specific names. Consensus on the laboratory targets and pack configuration was achieved by splitting statements into sub-sections. The rVIIa statement required three rounds of review to ensure the phrasing satisfied all the panelists for this controversial therapy. Interpretation: We believe that harmonization of MHPs in our region will simplify training, increase uptake of evidence-based interventions, enhance communication, improve patient safety, and ultimately improve outcomes. We highlight areas that need additional study: (1) RCTs are needed to determine if MHPs improve patient outcomes. (2) A "streamlined" version for community hospitals for stabilization before transfer to a tertiary care centre must be tested. (3) Activation and termination criteria have not been validated. (4) The frequency and type of laboratory testing has not been investigated. (5) Laboratory targets for resuscitation must be tested. (6) Does maintaining normothermia decrease transfusion? (7) Can fibrinogen concentrates and PCCs can be considered equivalent to cryoprecipitate and plasma, respectively? (8) Does compliance with the selected quality indicators result in improved outcome? These MHP recommendations will provide the basis for the design of local MHPs including specific recommendations for pediatric patients and for hospitals where definitive hemorrhage control may not be available. Disclosures Arnold: Novartis: Honoraria, Research Funding; Bristol-Myers Squibb: Research Funding; Rigel: Consultancy, Research Funding; Principia: Consultancy. Pai:Novartis: Honoraria. Sholzberg:Takeda: Honoraria, Research Funding; Baxalta: Honoraria, Research Funding; Baxter: Honoraria, Research Funding. Zeller:Canadian Blood Services: Consultancy; Pfizer: Other: Advisory Board; Ontario Ministry of Health and Long Term Care: Consultancy. Pavenski:Ablynx: Honoraria, Research Funding; Bioverativ: Research Funding; Shire: Honoraria; Alexion: Honoraria, Research Funding; Octapharma: Research Funding.

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