Open Access Open Access  Restricted Access Subscription or Fee Access

Identifying priorities for improvement of the quality of personal care in patients undergoing radiotherapy for prostate cancer

Kimberley A Foley, Patti A Groome, Yingwei Peng, Deb Feldman-Stewart, Michael D Brundage, William J Mackillop

Abstract


Background: We previously developed a questionnaire to assess the quality of personal care in prostate cancer radiotherapy. Patients are asked to rate the importance of 143 elements of their care and to rate the quality of their care for each element. In order to improve the quality of care delivered to patients, the elements of care most in need of improvement must be identified.

Objective: To develop a method of integrating ratings of importance and ratings of quality to identify elements of care that should become targets for quality improvement.

Methods: We surveyed 108 patients undergoing radiotherapy for prostate cancer. We developed 3 methods to identify elements of care to target for quality improvement that were important to the patient(s) and suboptimal in quality. Spearman correlation was used to compare ranking of priorities across all 3 methods. Generalized estimating equations were used to assess the statistical ability of the methods to discriminate between priorities for quality improvement.

Results: Integrating importance and quality ratings identified different priorities than using quality ratings alone. Two of the integrated methods identified priorities for quality improvement and their ranks similarly (r=0.91, p<0.0001). All methods identified elements related to communication of information about the disease and its treatment as priorities.

Conclusions: Two methods produced similar results although one is easier to understand and theoretically superior since the ratings for importance and quality are linked for each individual. Further consultation with stakeholders will determine how to use these results as part of a quality improvement program.

Keywords


Experience, health services research, patient-centered care, person-centered healthcare, prostate cancer, quality, quality improvement, quality measurement

Full Text:

PDF

References


Lohr, K.N. (1990). Medicare: A strategy for quality assurance. Washington, DC: National Academy Press.

Donabedian, A. (2005). Evaluating the quality of medical care. 1966. The Milbank Quarterly 83 (4) 691-729.

Foley, K.A., Feldman-Stewart, D., Groome, P.A., Brundage, M.D., McArdle, S., Wallace, D., Peng, Y. & Mackillop, W.J. (2016). What Aspects of Personal Care Are Most Important to Patients Undergoing Radiation Therapy for Prostate Cancer? International Journal of Radiation Oncology, Biology, Physics 94 (2) 280-288.

Donabedian, A. (1997). The quality of care. How can it be assessed? 1988. Archives of Pathology & Laboratory Medicine 121 (11) 1145-1150.

Darby, C. (2004). Measuring the patient’s perspective on the interpersonal aspects of cancer care. In: Outcomes assessment in cancer: measures, methods, and applications. Lipscomb, J., Gotay, C. & Snyder, C., (Eds.), pp. 290-304. Cambridge, England: Cambridge University Press.

Haggerty, J.L. (2010). Are measures of patient satisfaction hopelessly flawed. British Medical Journal 341, c4783.

Tasa, K., Baker, G.R. & Murray, M. (1996). Using patient feedback for quality improvement. Quality Management in Healthcare 4 (2) 55-67.

Campbell, S.M., Braspenning, J., Hutchinson, A. & Marshall, M.N. (2003). Research methods used in developing and applying quality indicators in primary care. British Medical Journal 326 (7393) 816-819.

Brien, S., Dixon, E. & Ghali, W. (2009). Measuring and Reporting on Quality in Health Care: A Framework and Road Map for Improving Care. Journal of Surgical Oncology 99 (8) 462-466.

Brien, S.E., Lorenzetti, D.L., Lewis, S., Kennedy, J. & Ghali, W.A. (2010). Overview of a formal scoping review on health system report cards. Implementation Science 5 (1) 2.

Mannion, R. & Davies, H.T. (2002). Reporting health care performance: learning from the past, prospects for the future. Journal of Evaluation in Clinical Practice 8 (2) 215-228.

Freeman, T. (2002). Using performance indicators to improve health care quality in the public sector: a review of the literature. Health Services Management Research 15 (2) 126-137.

Robert, G. (2013). Rethinking policy approaches to measuring and improving patient experience. Journal of Health Services Research & Policy 18 (2) 67-69.

Russell, S. (2013). Patients’ experiences: Top heavy with Research [Internet]. Research Matters: Melbourne. [cited 2015 Apr 8]. Available from: http://www.research-matters.com.au/publications/PatientsExperiencesReview.pdf

Martilla, J.A. & James, J.C. (1977). Importance-performance analysis. Journal of Marketing 41 (1) 77-79.

SAS. (2011). Cary, NC, USA: SAS Institute.

Gleeson, H., Calderon, A., Swami, V., Deighton, J., Wolpert, M. & Edbrooke-Childs, J. (2016). Systematic review of approaches to using patient experience data for quality improvement in healthcare settings. BMJ Open 6 (8) e011907.

Mohammed, K., Nolan, M.B., Rajjo, T., Shah, N.D., Prokop, L.J., Varkey, P. & Murad, M.H. (2016). Creating a patient-centered health care delivery system: a systematic review of health care quality from the patient perspective. American Journal of Medical Quality 31 (1) 12-21.

Fröjd, C., Swenne, C.L., Rubertsson, C., Gunningberg, L. & Wadensten, B. (2011). Patient information and participation still in need of improvement: evaluation of patients’ perceptions of quality of care. Journal of Nursing Management 19 (2) 226-236.

Booij, J.C., Zegers, M., Evers, P.M.P.J., Hendriks, M., Delnoij, D.M.J. & Rademakers, J.J.D.J.M. (2013). Improving cancer patient care: development of a generic cancer consumer quality index questionnaire for cancer patients. BMC Cancer 13, 203.

Sullivan, G.M. & Artino, A.R. (2013). Analyzing and Interpreting Data From Likert-Type Scales. Journal of Graduate Medical Education 5 (4) 541-542.

Ouwens, M., Hermens, R., Hulscher, M., Vonk-Okhuijsen, S., Tjan-Heijnen, V., Termeer, R., Marres, H., Wollersheim, H. & Grol, R. (2010). Development of indicators for patient-centred cancer care. Support Care in Cancer 18 (1) 121-130.

Trauer, T. & Mackinnon, A. (2001). Why are we weighting? The role of importance ratings in quality of life measurement. Quality of Life Research 10 (7) 579-585.

Al-Abri, R. & Al-Balushi, A. (2014). Patient satisfaction survey as a tool towards quality improvement. Oman Medical Journal 29 (1) 3.

Flott, K.M., Graham, C., Darzi, A. & Mayer, E. (2016). Can we use patient-reported feedback to drive change? The challenges of using patient-reported feedback and how they might be addressed. BMJ Quality & Safety 26 (6) 502-507.

Canadian Health Services Research Foundation. (2008). Performance reporting to help organizations promote quality improvement. Healthcare Policy 4 (2) 70-74.

Wallace, J., Teare, G.F., Verrall, T. & Chan, B.T. (2007). Public reporting on the quality of healthcare: emerging evidence on promising practices for effective reporting. Available from: http://www.cfhi-fcass.ca/SearchResultsNews/07-09-07/df3cb521-037d-4d94-a658-bec0d9fe0013.aspx

Coulter, A., Locock, L., Ziebland, S. & Calabrese, J. (2014). Collecting data on patient experience is not enough: they must be used to improve care. British Medical Journal 348, g2225.

van den Berg, M.J., Kringos, D.S., Marks, L.K. & Klazinga, N.S. (2014). The Dutch health care performance report: seven years of health care performance assessment in the Netherlands. Health Research Policy and Systems 12 (1) 1.

Gagliardi, A., Lemieux-Charles, L., Brown, A., Sullivan, T. & Goel, V. (2008). Stakeholder preferences for cancer care performance indicators. International Journal of Health Care Quality Assurance 21 (2) 175-189.




DOI: http://dx.doi.org/10.5750/ejpch.v6i4.1564

Refbacks

  • There are currently no refbacks.