How to Scale Up Quality and Safety Program with the Home Care Accreditation.

Laura Brunelli,Cristina De Sarno,Simone Pauletto,Silvio Brusaferro,Corrado Tosetto,Anna Paola Agnoletto,Anna Catelani,Claudio Battistella,Bruna Odasmini,Paola Stenico,Vittorio Cristofori

doi:10.5334/ijic.5698

Abstract

Introduction:The growing number of older people and the increasing burden of non-communicable diseases highlight the need for the integration between social and health services. To ensure high quality home care, common and consistent standards are essential. Our aim is to develop a validated accreditation tool for home care.Description:An integrated home care accreditation tool was developed including 26 standards and 144 items divided into six domains: Organization&Governance, Patient Safety&Risk Management, Professionals knowledge, Skills&Competences, Information&Communication, Care Integration, and Improvement&Innovation. Expert evaluation was conducted between August and November 2019; relevance and feasibility (RF) and expert agreement were analyzed.Discussion:A total of 21 experts participated in the validation process, with a response rate of 53%. A good RF score and agreement were obtained for 70% of the items and 65% of the standards. The best scores were obtained for Individualized care project (RF 8.4, agreement 100%), Integrated care pathways (RF 7.5, agreement 81%), Access to the integrated health and social care system (RF 8.1, agreement 86%), and Multidimensional assessment of needs (RF 8.1, agreement 86%).Conclusion:The existence of an integrated health and social care accreditation tool would help to improve the quality of home care, and make patients’ quality of life better and safer.

Highlights

The growing number of older people and the increasing burden of noncommunicable diseases highlight the need for the integration between social and health services
The best scores were obtained for Individualized care project (RF 8.4, agreement 100%), Integrated care pathways (RF 7.5, agreement 81%), Access to the integrated health and social care system (RF 8.1, agreement 86%), and Multidimensional assessment of needs (RF 8.1, agreement 86%)
The existence of an integrated health and social care accreditation tool would help to improve the quality of home care, and make patients’ quality of life better and safer

Summary

Introduction

The growing number of older people and the increasing burden of noncommunicable diseases highlight the need for the integration between social and health services. Description: An integrated home care accreditation tool was developed including 26 standards and 144 items divided into six domains: Organization&Governance, Patient Safety&Risk Management, Professionals knowledge, Skills&Competences, Information&Communication, Care Integration, and Improvement&Innovation. Italian public healthcare on a regional basis guarantees universal health coverage, even if the quality of the services provided may vary from one region to another [5]. This heterogeneity is a consequence of the 2001 constitutional reform, which entrusted the organization and management of healthcare services to Italian regions and autonomous provinces [6]. Integrating services contributes to better access to and continuity of high-quality services, especially for frail older people and patients with chronic conditions and disabilities [10], and integrated care is likely to reduce costs and improve outcomes [11]. Several key issues are required to merge the two services, including political support, shared governance, stakeholder commitment, organizational change, national coordination, staff training, patient empowerment, improved funding and incentive mechanisms, shared health information and monitoring systems [12]

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Conclusion