The needs of key-stakeholders for evaluating client’s experienced quality of home care: a qualitative approach

Background To optimize home care, it is essential to determine how care recipients experience quality of care. Traditionally, quality of care is measured with normative quality indicators such as safety, efficiency, or prevalence rates such as falls. The growing interest for qualitative patient-reported experience measures in home care requires insight into the needs of care receivers, providers, and organizations as key-stakeholders. Each stakeholder has their own needs that are important to communicate and use to conduct thorough comparisons before implementing new experience measures. This study aims to understand the needs of clients, formal/informal caregivers, and managers/policy officers in measuring client’s experienced quality of care in home care. Methods Four focus group interviews and 25 semi-structured interviews with key-stakeholders were conducted and analyzed by means of content analysis. The value-proposition canvas was used as a thematic framework to explore the purpose of experience quality of care measures and related pains and gains. Results There were two main purposes for measuring experienced quality of care: first improving the primary care process of individual clients and second for learning and improving in home care team. Using experienced quality of care measures for external accountability and transparency on an organizational or national level were considered less relevant. Among others, participants described not having time and no clear procedure for conducting an evaluation as a pain of the current methods used to evaluate perceived quality of home care. As gains they put forward the ability to informally evaluate experiences during care delivery and to openly discuss complaints with a familiar caregiver. Conclusions This study advocates that home care organizations should be aware of the goal of quality of care measures. They should consider selecting experienced quality of care measures mainly for improving primary care processes of individual clients. The results also underline the relevance of adopting next to quantitative evaluations, more narrative evaluation methods which support communicating openly on care experiences, leading to concrete point-of-improvement. The findings of this study can serve as a guide for both the development or selection of adequate methods, from the perspectives of key-stakeholders, in assessing experienced quality in home care.

Evaluating the Quality of Home Care in China Using the Home Care Quality Assessment Tool

Introduction This study aimed to evaluate the quality of home care in China using the Home Care Quality Assessment Tool (HCQuAT). Method We recruited 38 home health agencies in Shanghai, China, which included 18 in urban areas, 11 in suburban areas, and nine in rural areas. Data on quality of home care from each agency were collected by trained staff using the HCQuAT. Results On average, these home health agencies scored 74.28/100.00 ( SD = 6.80) on the HCQuAT, with an excellence rate of 39.5% and a failing rate of 23.7%. The mean scores on the structure quality module, process quality module, and outcome quality module were 71.2 ± 21.8, 86.6 ± 9.2, and 44.1 ± 37.5, respectively. Significant differences existed across geographic locations ( p = .018). Discussion Significant variations were identified in the quality of home care across quality modules and geographic locations. Outcome quality and quality in rural areas were lower than those for their counterparts.

Where Are We and What Shall We Do Next? A Qualitative Study of the Quality of Home Care in Shanghai, China

Introduction: With the increasing need for home care in Shanghai, China, it is crucial to ensure its quality. This study aimed to explore quality-related issues of home care in Shanghai, China, and identify strategies for improvement. Method: This is a descriptive qualitative study. Semistructured interviews were conducted among 27 individuals, including home care managers ( n = 8), nurses ( n = 10), and patients and/or their caregivers ( n = 9). Colaizzi’s seven-step analysis method was used to guide data analysis. Results: Three themes emerged regarding the quality of home care in China: unsatisfactory structure quality, unsatisfactory process quality, and imperfect outcome quality evaluation system. Recommended strategies for quality improvement included issuing standards for home care evaluation, refining structure quality and process quality, and establishing an outcome quality evaluation system. Conclusions: Concerns about the quality of home care in China were identified by providers and patients. More research especially studies quantifying the care quality and its influencing factors are needed.

QUALITY INDICATORS FOR STROKE PATIENTS AT HOME-BASED CARE SETTING: A REVIEW

Background: One method to identify the level of performance is using quality of care indicators. Even though many quality indicators of health care have been announced, those which specify in home care services are limited in that none of them describe the stroke patients’ condition. The purposes of this study are to determine through systematic literature review what methods can be used to assess the quality of home care that patients received and to identify what components can be used as a determinant of the quality of home care services. Method: Google Scholar, EBSCO, ProQuest and PubMed database websites were searched for articles and information. Results: The method that was used is a qualitative study using a literature review with quantitative analysis of a previously accepted research instrument with a questionnaire that has been widely available and considered reliable. The researchers identified thematic differentiation in grouping the quality indicators used by those articles, however most of them are classified as outcome indicators, one as process indicator, and none as structure or input indicator. Overall quality indicators in home care that are used by the three articles are based on the Home Care Quality Indicators Instrument (HCQIs). Conclusions: Several studies discussed home care quality indicators but no articles specifically analyze home care provision for stroke patients. Further research is needed to clarify the components indicators for stroke patients and more importantly, these indicators should be valid, and reliable.