Measurement of patient experiences leads to better care

Nursing homes, homes for the elderly and home care organizations that previously received a relatively poor assessment of patients, have improved their care. Their performance could have been even better if clients had been actively involved in implementing improvements. This is what Marloes Zuidgeest concludes in her PhD-thesis. The study was a joint effort of Tranzo, NIVEL and the Dutch Centre for Consumer Experience in Health Care.

In the Netherlands, the experiences of clients with the quality of care are measured using standardized questionnaires, the Consumer Quality Index (CQI or CQ-index). In development, testing and adapting questionnaires, input by clients themselves is mandatory and organized e.g. through focus group discussions and cognitive testing. However, when using the results to improve the care, clients and client councils are often not actively involved. Moreover, client councils of nursing homes and homes for the elderly have legal rights to give advice and to indicate quality improvement priorities. However, they make too little use of these powers. In practice, mostly the management of a healthcare organization determines how information about client experiences is used in quality policy. Improvements are made, but the performance of healthcare organizations is likely to improve even further if clients are actually involved in quality initiatives.

Standard
The Consumer Quality index (CQ-index) is the Dutch standard for measuring patients’ experiences with quality of care. This methodology provides information that can be used for quality improvement. The research of Zuidgeest shows that the CQI methodology provides scientifically valid and reliable data which are recognizable for clients and which are a relevant addition to clinical information. However, there are points for improvement. In the development phase of CQI questionnaires, more attention should be paid to the interview methodology to ensure that clients comprehend the questions in the questionnaire. In addition, the results should be presented in such a way that clients understand the results and that client councils together with the management and the professionals in the healthcare organization actually use this information.

Funding
- NWO
- Ministerie of Education, Culture and Science

Cooperating partners
- Tilburg University, Tranzo
- Centrum Klantervaring zorg