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International Journal for Quality in Health Care Advance Access originally published online on September 7, 2006
International Journal for Quality in Health Care 2006 18(6):397-402; doi:10.1093/intqhc/mzl044
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International Journal for Quality in Health Care vol. 18 no. 6 © The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved

Effects of visitation among allied health professionals

Hannelore Hofhuis1, Cornelia H. M. Van Den Ende2 and Dinny H. De Bakker1

1 Netherlands Institute for Health Services Research, Utrecht and 2 Department of Pediatric Oncology-Hematology, University Medical Centre Nijmegen, Nijmegen, The Netherlands

Objective. Visitation is a method for external peer review. The goal is to improve the quality of patient care by giving feedback on quality of competence and performance of a professional during a practice visit. Feedback is offered as recommendations for improvement. This study aims to evaluate the effects of visitation and to determine which factors are related to the effectiveness of visitation.

Participants. Members of seven allied health professions in the Netherlands: dieticians, exercise therapists, physiotherapists, dental hygienists, occupational therapists, podiatrists, and radiology assistants.

Design. Evaluation questionnaires were sent to 151 allied health professionals who had participated in visitation. The questions included all practice management aspects that had been assessed during the practice visit. The effects of visitation were studied at three levels: change in awareness of weak and strong aspects of competence and performance, intention to carry out recommendations, and actual improvements.

Results. Results showed effects of visitation on all three levels. Respondents intended to carry out two-thirds of the recommendations. Visitation led to a better awareness of weak points on 36% of the aspects and better awareness of strong points on 53% of the aspects of practice management. Young respondents reported more changes in awareness than older respondents. Actual improvements were carried out on 33% of the aspects.

Conclusions. Visitation is an effective method to stimulate quality improvement in allied health professionals. Although changes in awareness more often occurred in younger respondents, actual improvements were made by all respondents.

Keywords: peer review, quality assessment, quality improvement, visitation

Address reprint requests to Hannelore Hofhuis, Netherlands Institute for Health Services Research, Utrecht, The Netherlands. E-mail: h.hofhuis{at}nivel.nl

Accepted for publication August 14, 2006.


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