Acceptability of Australian prehospital care quality indicators: An explanatory sequential mixed methods study

Abstract

Background Systematically developed quality indicators (QIs) facilitate the measurement and monitoring of quality of care and ultimately meaningful quality improvement. The aim of this study was to evaluate the acceptability of a predetermined suite of 84 scientifically valid prehospital care QIs from the provider perspective. Methods An explanatory sequential mixed methods study design was used. Quantitative data were obtained from 36 participants of an online survey in which they rated the acceptability of the QIs using a five-point numerical rating scale. Qualitative data were gathered by conducting semi-structured interviews with a purposive sample of nine survey participants. The successional collection of quantitative and qualitative data facilitated integrated interpretations and conclusions about the acceptability of the QIs. Results Generally, the acceptability of all QIs in the suite was rated highly. Data suggested a positive association between acceptability and other key characteristics of QIs. QIs that were seen as clear, supported by scientific evidence, practical and meaningful tended to be more acceptable than those which were not. The benefits of outcome type QIs were recognised, but participants raised concerns about their sensitivity in the measurement of prehospital quality of care. To be acceptable, QIs which included time intervals needed to be specific about time-critical interventions. Further, the high acceptability of the QIs was explained by a connection to participants’ professional values and qualities. Assessing the QIs’ acceptability from a healthcare provider perspective meant that QIs on patient satisfaction frequently received lower ratings. Conclusion The findings of this study provide evidence of the acceptability of prehospital care providers of a proposed suite of QIs. Future research should evaluate the feasibility and reliability of the QIs. There is also a need to investigate how acceptable the proposed QIs are to patients and communities.