Abstract
ObjectiveStakeholders of hospitals often lack standardized tools to assess compliance with quality management strategies and the implementation of clinical quality activities in hospitals. Such assessment tools, if easy to use, could be helpful to hospitals, health-care purchasers and health-care inspectorates. The aim of our study was to determine the psychometric properties of two newly developed tools for measuring compliance with process-oriented quality management strategies and the extent of implementation of clinical quality strategies at the hospital level.DesignWe developed and tested two measurement instruments that could be used during on-site visits by trained external surveyors to calculate a Quality Management Compliance Index (QMCI) and a Clinical Quality Implementation Index (CQII). We used psychometric methods and the cross-sectional data to explore the factor structure, reliability and validity of each of these instruments.Setting and ParticipantsThe sample consisted of 74 acute care hospitals selected at random from each of 7 European countries.Main Outcome MeasuresThe psychometric properties of the two indices (QMCI and CQII).ResultsOverall, the indices demonstrated favourable psychometric performance based on factor analysis, item correlations, internal consistency and hypothesis testing. Cronbach's alpha was acceptable for the scales of the QMCI (α: 0.74–0.78) and the CQII (α: 0.82–0.93). Inter-scale correlations revealed that the scales were positively correlated, but distinct. All scales added sufficient new information to each main index to be retained.ConclusionThis study has produced two reliable instruments that can be used during on-site visits to assess compliance with quality management strategies and implementation of quality management activities by hospitals in Europe and perhaps other jurisdictions.
Highlights
In a more and more market-oriented health-care delivery system it may be increasingly important to evaluate the quality of care delivered
This study has produced two reliable instruments that can be used during on-site visits to assess compliance with quality management strategies and implementation of quality management activities by hospitals in Europe and perhaps other jurisdictions
In this article we describe the development of two novel quality management indices for purchasers and other stakeholders of European hospitals
Summary
In a more and more market-oriented health-care delivery system it may be increasingly important to evaluate the quality of care delivered. Easy-to-use survey instruments have not been developed for use by health-care purchasers or health-care inspectorates Such instruments could be used to reveal whether a hospital has appropriate quality management strategies in place, whether they are used and whether they are stimulating continuous learning and improvement. The latter is based on the Deming or Nolan Quality Improvement Cycle, which describes the steps: Plan–Do–Check/study–Act. On-site visits offer an opportunity to discuss achievement of more complex steps like ‘Check and Act’. Widely used quality indicators can rarely be used to measure the improvement structures and culture of hospital units, which can be explored in conversation during an on-site-visit
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