U Weibler-Villalobos1, B Röhrig.
Abstract
BACKGROUND: Since 2009 there is a legal obligation in Germany to provide quality reports for all nursing facilities. OBJECTIVE AND METHODS: Criteria for measuring and presenting the quality of care defined for health services are applied to the area of nursing care. The German Nursing-Transparency-Order for nursing homes has been compared with those attributes.
RESULTS: Prior to realisation of the concept of publishing quality reports of care facilities, the definition of high-quality care standards, an explicit objective for quality reporting and the definition of addressees are required. The quality indicators to be derived must be relevant from the user's point of view as well as from professional perspectives. Benefits and undesirable effects must be weighted out mutually. Relevant for the choice of quality indicators are the methodical attributes: strength of evidence, precision of definitions, ability of discrimination, reliability and validity. To make the results comparable between facilities, it is suggested to include an equally stratified random sampling of persons. An aggregation or summation of the results may basically only occur when the results have a common content coherence (correlation) and the same importance (weighting). Through explicit specifications for the assessment, for example, so-called knock-out criteria, it must be assured that in essential events like damages under non-expert care, there are no compensations by other results. The German Nursing-Transparency-Order for nursing homes fulfils only one part of the generally established methodical quality criteria.
CONCLUSION: The procedure for the choice of quality indicators must be made clear; the methodical quality must be tested and the test results must be published. Above all it must be proven with test results that the appraisal of experts and users agrees with the results of the nursing transparency (validity). An accompanying research is absolutely necessary. © Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND: Since 2009 there is a legal obligation in Germany to provide quality reports for all nursing facilities. OBJECTIVE AND METHODS: Criteria for measuring and presenting the quality of care defined for health services are applied to the area of nursing care. The German Nursing-Transparency-Order for nursing homes has been compared with those attributes.
RESULTS: Prior to realisation of the concept of publishing quality reports of care facilities, the definition of high-quality care standards, an explicit objective for quality reporting and the definition of addressees are required. The quality indicators to be derived must be relevant from the user's point of view as well as from professional perspectives. Benefits and undesirable effects must be weighted out mutually. Relevant for the choice of quality indicators are the methodical attributes: strength of evidence, precision of definitions, ability of discrimination, reliability and validity. To make the results comparable between facilities, it is suggested to include an equally stratified random sampling of persons. An aggregation or summation of the results may basically only occur when the results have a common content coherence (correlation) and the same importance (weighting). Through explicit specifications for the assessment, for example, so-called knock-out criteria, it must be assured that in essential events like damages under non-expert care, there are no compensations by other results. The German Nursing-Transparency-Order for nursing homes fulfils only one part of the generally established methodical quality criteria.
CONCLUSION: The procedure for the choice of quality indicators must be made clear; the methodical quality must be tested and the test results must be published. Above all it must be proven with test results that the appraisal of experts and users agrees with the results of the nursing transparency (validity). An accompanying research is absolutely necessary. © Georg Thieme Verlag KG Stuttgart · New York.
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Year: 2010
PMID： 20049676 DOI： 10.1055/s-0029-1242790
Source DB: PubMed Journal: Gesundheitswesen ISSN： 0941-3790