This study aimed at developing integrated clinical performance indicators(CPIs) through the analysis of quality improvement(QI) activities of a hospital and literature review about performance measures.
The CPIs were developed through the following three stages; 1)Identifying preliminary CPIs 2)A staff validity test in preliminary CPIs 3)Developing final CPIs.
One hundred twenty-three preliminary CPIs were developed through QI activities of the target hospital for 8 years and literature review. The results of the validity test for the preliminary CPIs supported ninety-one items. Sixty-two CPIs were selected through integration, reclassification and renaming. Then, eighteen items were deleted on account of an imprecise calculation method. Finally, forty-four CPIs were confirmed. They consisted of twenty-six items at the hospital level and eighteen items at the department level.
CPIs can be used as criteria to evaluate the performance of healthcare organizations, and to decide the quality of healthcare for customers. This study may contribute to establishing an integrated system between QI activities and performance measurement of healthcare organizations.
To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea.
The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals.
The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month.
This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.
This study was designed to develop Nursing Service Quality Indicators(NSQIs) in nursing homes that would lead to an appropriate evaluation and improvement of nursing service quality.
The preliminary NSQIs were developed through literature reviews and analysis of existing quality indicators. A content validity testing was done twice by using a panel of experts who were from academia and the clinical areas. The final NSQIs were confirmed and applied in three nursing homes to test feasibility.
The preliminary NSQIs had 4 domains and 31 indicators. Two content validity testings were performed. The indicators scoring over .80 CVI for each testing were selected and modified by experts' opinions. The final NSQIs consisted of7 domains and 33 indicators. They were applied in three nursing homes and it was revealed that all the indicators were applicable.
In this study, it is shown that this new 'Nursing Service Quality Indicators in Nursing Homes' is suitable for a holistic evaluation of nursing service quality of elderly patients in nursing homes. This NSQIs will be able to provide a basis for establishing nursing care standards and improving the nursing care quality in nursing homes.