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Claessens F, Seys D, Van der Auwera C, Castro EM, Jans A, Schoenmakers B, De Ridder D, Bruyneel L, Van Wilder A, Vanhaecht K. The FlaQuM-Quickscan: A starting point to include primary care professionals' perspectives in the evaluation of hospital quality priorities. J Healthc Qual Res 2024; 39:89-99. [PMID: 38195377 DOI: 10.1016/j.jhqr.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Today, primary care professionals' (PCPs) perspectives on hospital quality are unknown when evaluating hospital quality priorities. The aims of the present study were to identify key healthcare quality attributes from PCPs' perspective, to validate an instrument that measures PCPs' experiences of healthcare quality multidimensionally and to define hospital quality priorities based on PCPs' experiences. MATERIAL AND METHODS Focus groups with PCPs were conducted to identify quality attributes through a qualitative in-depth analysis. A multicentre study of 18 hospitals was used to quantitatively assess construct, discriminant and criterion validity of the FlaQuM-Quickscan, an instrument that measures 'Healthcare quality for patients and kin' (part 1) and 'Healthcare quality for professionals' (part 2). To set quality priorities, scores on quality domains were analyzed descriptively and between-hospital variation was examined by evaluating differences in hospitals' mean scores on the quality domains using one-way Analysis of Variance (ANOVA). RESULTS Identified key attributes largely corresponded with Lachman's multidimensional quality model. Including 'Communication' as a new quality domain was recommended. The FlaQuM-Quickscan was completed by 550 PCPs. Confirmatory factor analyses showed reasonable to good fit, except for the Root Mean Square Error of Approximation (RMSEA) in part 2. The 'Equity' domain scored the highest in parts 1 and 2. Domains 'Kin-centred care' and 'Accessibility and timeliness' scored the lowest in part 1 and 'Resilience' and 'Partnership and co-production' in part 2. Significant variation in hospitals' mean scores was observed for eleven domains in part 1 and sixteen domains in part 2. CONCLUSIONS The results gained a better understanding of PCPs' perspective on quality. The FlaQuM-Quickscan is a valid instrument to measure PCPs' experiences of hospital quality. Identified priorities indicate that hospital management should focus on multifaceted quality strategies, including technical domains, person-and kin-centredness, core values and catalysts.
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Affiliation(s)
- F Claessens
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium.
| | - D Seys
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - C Van der Auwera
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - E M Castro
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium; Department of Quality Management, Regionaal Ziekenhuis Heilig Hart Tienen, Tienen, Belgium
| | - A Jans
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium; Department of Quality Management, Sint-Trudo Ziekenhuis, Sint-Truiden, Belgium
| | - B Schoenmakers
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - D De Ridder
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium; Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
| | - L Bruyneel
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - A Van Wilder
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - K Vanhaecht
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium; Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
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Smetcoren AS, Dury S, De Donder L, Dierckx E, De Witte N, Engelborghs S, De Deyn PP, van der Vorst A, Van der Elst M, Lambotte D, Hoeyberghs L, Fret B, Duppen D, De Roeck E, Kardol M, Schoenmakers B, De Lepeleire J, Zijlstra GAR, Kempen GIJM, Schols JMGA, Verté D. [Detection and prevention in later life: risk profiles for physical, psychological, social and environmental frailty.]. Tijdschr Gerontol Geriatr 2017; 49:1-11. [PMID: 29181776 DOI: 10.1007/s12439-017-0241-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In order to provide proactive care and support for older people attention is needed for the prevention of frailty among older adults. Subsequently, accurate case finding of those who are more at risk of becoming frail is crucial to undertake specific preventive actions. This study investigates frailty and risk profiles of frailty among older people in order to support proactive detection. Hereby, frailty is conceived not only as a physical problem, but also refers to emotional, social, and environmental hazards. Using data generated from the Belgian Ageing Studies (N = 21,664 home-dwelling older people), a multinomial logistic regression model was tested which included socio-demographic and socio-economic indicators as well as the four dimensions of frailty (physical, social, psychological and environmental). Findings indicate that for both men and women having moved in the previous 10 years and having a lower household income are risk factors of becoming multidimensional frail. However, studying the different frailty domains, several risk profiles arise (e. g. marital status is important for psychological frailty), and gender-specific risk groups are detected (e. g. non-married men). This paper elaborates on practical implications and formulates a number of future research recommendations to tackle frailty in an ageing society.
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Affiliation(s)
- A S Smetcoren
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België.
| | - S Dury
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België
| | - L De Donder
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België
| | - E Dierckx
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België.,Klinische en Levenslooppsychologie, Vrije Universiteit Brussel, Brussel, België
| | - N De Witte
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België.,Faculteit Mens en Welzijn, Hogeschool Gent, Gent, België
| | - S Engelborghs
- Biomedische Wetenschappen, Universiteit Antwerpen, Antwerpen, België
| | - P P De Deyn
- Biomedische Wetenschappen en Geneeskunde, Universiteit Antwerpen, Antwerpen, België
| | - A van der Vorst
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Nederland
| | - M Van der Elst
- Academisch Centrum voor Huisartsgeneeskunde, KU Leuven, Leuven, België
| | - D Lambotte
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België
| | - L Hoeyberghs
- Faculteit Mens en Welzijn, Hogeschool Gent, Gent, België
| | - B Fret
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België
| | - D Duppen
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België
| | - E De Roeck
- Klinische en Levenslooppsychologie, Vrije Universiteit Brussel, Brussel, België.,Biomedische Wetenschappen, Universiteit Antwerpen, Antwerpen, België
| | - M Kardol
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België
| | - B Schoenmakers
- Academisch Centrum voor Huisartsgeneeskunde, KU Leuven, Leuven, België
| | - J De Lepeleire
- Academisch Centrum voor Huisartsgeneeskunde, KU Leuven, Leuven, België
| | - G A R Zijlstra
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Nederland
| | - G I J M Kempen
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Nederland
| | - J M G A Schols
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Nederland
| | - D Verté
- Educatiewetenschappen, Vrije Universiteit Brussel, Brussel, België
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Van der Elst M, Schoenmakers B, Verté D, De Donder L, De Witte N, De Lepeleire J. THE RELATION BETWEEN EARLY RETIREMENT AND THE ONSET OF FRAILTY IN BELGIAN OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - D. Verté
- Free University Brussels, Brussels, Belgium,
| | | | - N. De Witte
- Free University Brussels, Brussels, Belgium,
- University College Ghent, Ghent, Belgium
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Abstract
BACKGROUND Appropriate prescribing for older people is a challenge. General practitioners (GPs) are aware of their key position in relation to prescribing practice in the elderly. However, they often feel powerless and report a need for simple GP friendly tools to assess and support their prescribing practice. OBJECTIVES In this study such a tool is developed: the Appropriate Medication for Older people-tool (AMO-tool). The purpose of the study is to investigate whether GPs consider the use of the AMO-tool to be practically feasible and resulting in more appropriate prescribing. DESIGN This pilot study with an interventional design was conducted over a period of six months. SETTING The study was conducted in nursing homes visited by GPs. PARTICIPANTS The studied population consisted of nine GPs and 67 nursing home residents. INTERVENTION The intervention consisted of the use of the AMO-tool. MEASUREMENTS The Short Form (SF)-12 questionnaire was administered to the patients. Patients' medication lists were recorded. The GPs completed a semi-quantitative questionnaire on their experiences with the AMO-tool. A descriptive qualitative and semi-quantitative analysis was carried out on the GP questionnaire. The results of the SF-12 questionnaires and medication lists were analysed quantitatively. A multivariate analysis was carried out. RESULTS In the perception of GPs, applying the AMO-tool to medication lists of nursing home residents was feasible and resulted in more appropriate prescribing. A slight reduction was recorded in the number of medications prescribed. Self-reported well-being improved and rose in parallel with the number of medication changes. CONCLUSION According to GPs, the AMO-tool offers GPs the support in their prescribing practice. Changes are made to medication lists and improvements occur in patients' self-reported well-being. Future research should objectify the appropriateness of prescriptions before and after using the tool. Furthermore, it should investigate the possible causal relationship between the use of the AMO-tool, an increase in appropriateness of medication lists and an improvement of general well-being.
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Affiliation(s)
- E Lenaerts
- Prof Dr. Birgitte Schoenmakers, Academic Centre of General Practice, University Leuven, Kapucijnenvoer 33, block J, box 7001, tel. +32 16 3 32732,
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