Abstract
BackgroundThe culture shift in nursing homes from task-oriented to person-centered care has created a need to assess clients’ experienced quality of care (QoC), as this corresponds best with what matters to them. This study aimed to gain insight into how to assess experienced QoC in nursing homes from the client’s perspective.MethodA qualitative study was performed consisting of a focus group with client representatives (n = 10), a focus group with nursing home staff (n = 9) and a world café with client representatives and staff recruited from the Living Lab in Ageing & Long-Term Care (n = 24). Three questions about assessing experienced QoC from the client’s perspective were addressed during data collection: 1) What content needs to be assessed? 2) What assessment procedures are needed? and, 3) Who needs to be involved in the assessment? Semi-structured questions, photo elicitation and creative writing were used to answer these questions. Conventional content analysis was used to analyze the data.ResultsParticipants indicated that experienced QoC mostly occurs within the interactions between clients, family and staff, highlighting the impact of relationships. They suggested assessments should focus on three aspects: 1) knowledge about the client, 2) a responsive approach, and 3) a caring environment. These can be assessed by having conversations with clients, their families and staff, and additionally observing the clients in their living environments. Sufficient time and resources are prerequisites for this. Additionally, the person performing the quality assessments needs to possess certain communication and empathy skills.ConclusionIt is important to include the perspectives of the client, family and staff when assessing experienced QoC, in line with the principles underlying relationship-centered care. In order to be feasible, it is recommended to incorporate quality assessments into the nursing homes’ daily routines. Further research with clients, family and staff in nursing homes is needed to develop a feasible, reliable and valid method that assesses experienced QoC from the client’s perspective.
Highlights
The culture shift in nursing homes from task-oriented to person-centered care has created a need to assess clients’ experienced quality of care (QoC), as this corresponds best with what matters to them
Participants indicated that experienced QoC mostly occurs within the interactions between clients, family and staff, highlighting the impact of relationships
It is important to include the perspectives of the client, family and staff when assessing experienced QoC, in line with the principles underlying relationship-centered care
Summary
The culture shift in nursing homes from task-oriented to person-centered care has created a need to assess clients’ experienced quality of care (QoC), as this corresponds best with what matters to them. Western countries are struggling to consistently improve quality of care (QoC) in nursing homes [1]. Research has shown that clients’ and families’ experiences offer less tangible information on QoC, such as the importance of feeling at home, being empowered and maintaining dignity [12, 13] These insights have resulted in the need to incorporate these perspectives when assessing experienced QoC in nursing homes [11, 14,15,16]. In other countries similar developments are occurring [19]
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