Systematic quality measurement of hospice care - lessons learned from implementation process in the Czech Republic : a qualitative approach
Abstract
Aim: Any systematic tool to evaluate the quality of hospice care has been lacking in the Czech Republic. Based on the international literature and using the service provider's involvement approach, we have developed a set of quality indicators, combining data from a patient medical record, organizational data, and questionnaire survey for bereaved family caregivers.
This study aims to analyze the implementation of our novel quality measurement tool, with a focus on the feasibility, content, and perception of the tool by the service providers. Methods: The implementation of the tool was piloted over the period of 9 months in 5 hospices, 2 residential and 3 community services, operating in 4 regions.
Data were collected from managers and staff members engaged in the implementation process. Two methods were used: semi-structured interviews (n=10) and three online workshops (n=6/4/8).
All collected data were analyzed according to the principles of thematic analysis. Results: The findings indicate that the quality measurement tool was well accepted.
Following domains were assessed: (i) feasibility- a workload connected with the tool did not cause any staff resistance and the tool was perceived as suitable; (ii) content- the design was assessed as user-friendly but most participants suggested changes in the patient medical record form; (iii) service improvement- the tool helped service providers to identify areas relevant for service improvement such as changes in in-house documentation and communication with bereaved relatives. Conclusion: The tool is seen as an appropriate and feasible approach towards improving the quality of hospice services.
Although including service providers in the development and implementation process was challenging it was crucial for the acceptance and future service improvement.