L Burla1, R Schaffert, M Mylaeus, P Rüesch. 1. Fachstelle Gesundheitswissenschaften, Departement Gesundheit, ZHAW Zürcher Hochschule für Angewandte Wissenschaften, Winterthur, Schweiz.
Abstract
PURPOSE: The aim of this study was to develop and examine quality indicators of home care in Switzerland using the Swiss version of the RAI-HC (Resident Assessment Instrument Home Care). The quality indicators are part of the quality management strategy of the 'Spitex Verband Schweiz', the organisation of Swiss home care institutions. METHODS: The study consisted of four steps. First, a set of potential quality indicators was operationalised. For this purpose, already defined indicators of the North American version of RAI-HC were adopted, also additional indicators based on the Swiss RAI-HC were developed. In a second step, the changeability, practicability and relevance of these quality indicators were judged by home care professionals using a group consensus method (nominal group technique). Third, based on a sample of 1808 clients from a total of 45 Swiss home care organisations, the quality indicators were empirically tested with regard to sample frequencies (incidences and prevalences) and between-group variance. Fourth, the interrater reliability of the quality indicators was assessed. RESULTS: A total of 29 potential home care quality indicators was developed. Based on the results of the three sub-studies (rating by experts, frequencies/variation and interrater reliability), a core-set of 19 quality indicators was defined which can be recommended for quality measurement in home care settings of Switzerland. CONCLUSIONS: The Swiss version of RAI-HC provides a viable instrument for measuring quality of home care. The application of consistent assessment rules should be improved. Copyright Georg Thieme Verlag KG Stuttgart . New York.
PURPOSE: The aim of this study was to develop and examine quality indicators of home care in Switzerland using the Swiss version of the RAI-HC (Resident Assessment Instrument Home Care). The quality indicators are part of the quality management strategy of the 'Spitex Verband Schweiz', the organisation of Swiss home care institutions. METHODS: The study consisted of four steps. First, a set of potential quality indicators was operationalised. For this purpose, already defined indicators of the North American version of RAI-HC were adopted, also additional indicators based on the Swiss RAI-HC were developed. In a second step, the changeability, practicability and relevance of these quality indicators were judged by home care professionals using a group consensus method (nominal group technique). Third, based on a sample of 1808 clients from a total of 45 Swiss home care organisations, the quality indicators were empirically tested with regard to sample frequencies (incidences and prevalences) and between-group variance. Fourth, the interrater reliability of the quality indicators was assessed. RESULTS: A total of 29 potential home care quality indicators was developed. Based on the results of the three sub-studies (rating by experts, frequencies/variation and interrater reliability), a core-set of 19 quality indicators was defined which can be recommended for quality measurement in home care settings of Switzerland. CONCLUSIONS: The Swiss version of RAI-HC provides a viable instrument for measuring quality of home care. The application of consistent assessment rules should be improved. Copyright Georg Thieme Verlag KG Stuttgart . New York.