International Journal for Quality in Health Care Advance Access originally published online on July 31, 2007
International Journal for Quality in Health Care 2007 19(5):281-288; doi:10.1093/intqhc/mzm029
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Evaluating quality of patient care communication in integrated care settings: a mixed method approach
1 Roessingh Research and Development, Institute for Research in Rehabilitation Medicine and Technology, Enschede, The Netherlands
2 Roessingh Research and Development, Institute for Research in Rehabilitation Medicine and Technology, Enschede, The Netherlands
3 University of Twente, Department of Communication Studies, Faculty of Behavioural Sciences, Enschede, The Netherlands
4 University of Twente, School of Management and Governance, Enschede, The Netherlands
Background. Owing to the involvement of multiple professionals from various institutions, integrated care settings are prone to suboptimal patient care communication. To assure continuity, communication gaps should be identified for targeted improvement initiatives. However, available assessment methods are often one-sided evaluations not appropriate for integrated care settings.
Objective. We developed an evaluation approach that takes into account the multiple communication links and evaluation perspectives inherent to these settings. In this study, we describe this approach, using the integrated care setting of Cerebral Palsy as illustration.
Methods/Results. The approach follows a three-step mixed design in which the results of each step are used to mark out the subsequent step's focus. The first step patient questionnaire aims to identify quality gaps experienced by patients, comparing their expectancies and experiences with respect to patient–professional and inter-professional communication. Resulting gaps form the input of in-depth interviews with a subset of patients to evaluate underlying factors of ineffective communication. Resulting factors form the input of the final step's focus group meetings with professionals to corroborate and complete the findings.
Conclusions. By combining methods, the presented approach aims to minimize limitations inherent to the application of single methods. The comprehensiveness of the approach enables its applicability in various integrated care settings. Its sequential design allows for in-depth evaluation of relevant quality gaps. Further research is needed to evaluate the approach's feasibility in practice. In our subsequent study, we present the results of the approach in the integrated care setting of children with Cerebral Palsy in three Dutch care regions.
Keywords: cerebral palsy, communication, health care evaluation mechanisms, patient care management
Address reprint requests to: Jitske Gulmans; Tel: +31-53-4875777; Fax: +31-53-4340849; E-mail: j.gulmans{at}rrd.nl
Accepted for publication June 9, 2007.