An evidence-based framework to measure quality of allied health care

BackgroundThere is no standard way of describing the complexities of allied health (AH) care, or its quality. AH is an umbrella term which excludes medicine and nursing, and variably includes disciplines which provide therapy, diagnostic, or scientific services. This paper outlines a framework for a standard approach to evaluate the quality of AH therapy services.MethodsA realist synthesis framework describing what AH does, how it does it, and what is achieved, was developed. This was populated by the findings of a systematic review of literature published since 1980 reporting concepts of quality relevant to AH. Articles were included on quality measurement concepts, theories, debates, and/or hypothetical frameworks.ResultsOf 139 included articles, 21 reported on descriptions of quality potentially relevant to AH. From these, 24 measures of quality were identified, with 15 potentially relating to what AH does, 17 to how AH delivers care, 8 relating to short term functional outcomes, and 9 relating to longer term functional and health system outcomes.ConclusionsA novel evidence-based quality framework was proposed to address the complexity of AH therapies. This should assist in better evaluation of AH processes and outcomes, costs, and evidence-based engagement of AH providers in healthcare teams.

[1]  R. Gershon,et al.  Development and application of the orthotics and prosthetics user survey: Applications and opportunities for health care quality improvement , 2006 .

[2]  L. Petersen,et al.  Passive Monitoring Versus Active Assessment of Clinical Performance: Impact on Measured Quality of Care , 2011, Medical care.

[3]  Ebrahim Jaafaripooyan,et al.  Healthcare accreditation systems: further perspectives on performance measures. , 2011, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[4]  D. Dougherty,et al.  Quality measures for children's health care. , 2004, Pediatrics.

[5]  A Donabedian,et al.  The seven pillars of quality. , 1990, Archives of pathology & laboratory medicine.

[6]  Karen Grimmer-Somers,et al.  Allied, scientific and complementary health professionals: a new model for Australian allied health. , 2009, Australian health review : a publication of the Australian Hospital Association.

[7]  J. Holmes,et al.  Beyond the initial indicators: lessons from the OECD Health Care Quality Indicators Project and the US National Healthcare Quality Report. , 2006, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[8]  Episodes of allied health outpatient care: an investigation of service delivery in acute public hospital settings , 2000, Disability and rehabilitation.

[9]  N. Afdhal,et al.  Health care quality measurement in the care of patients with cirrhosis. , 2010, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[10]  R. Kohli,et al.  Integrating cost information with health management support system: an enhanced methodology to assess health care quality drivers. , 1999, Topics in health information management.

[11]  W. Ghali,et al.  Measuring and reporting on quality in health care: A framework and road map for improving care , 2009, Journal of surgical oncology.

[12]  L. G. Pawlson,et al.  Leveraging Improvement in Quality and Value in Health Care Through a Clinical Performance Measure Framework: A Recommendation of the American College of Physicians , 2010, American journal of medical quality : the official journal of the American College of Medical Quality.

[13]  A. Williams,et al.  International classification of functioning, disability, and health: ICF-CY World Health Organization , 2013 .

[14]  Kaveh G Shojania,et al.  Trends in adverse events over time: why are we not improving? , 2013, BMJ quality & safety.

[15]  T. B. Üstün,et al.  Models of disablement, universalism and the international classification of impairments, disabilities and handicaps. , 1999, Social science & medicine.

[16]  The use of RCT's in manual therapy--are we trying to fit a round peg into a square hole? , 2011, Manual therapy.

[17]  Chen Mk.  The K index: a proxy measure of health care quality. , 1976 .

[18]  Mosad Zineldin,et al.  The quality of health care and patient satisfaction: an exploratory investigation of the 5Qs model at some Egyptian and Jordanian medical clinics. , 2006, International journal of health care quality assurance incorporating Leadership in health services.

[19]  D. Berwick.  Toward an Applied Technology for Quality Measurement in Health Care , 1988, Medical decision making : an international journal of the Society for Medical Decision Making.

[20]  Sajay Arthanat,et al.  Assistive technology device classification based upon the World Health Organization's, International Classification of Functioning, Disability and Health (ICF) , 2011, Disability and rehabilitation. Assistive technology.

[21]  M. Terblanche,et al.  The evolution of intensive care unit performance assessment. , 2006, Journal of critical care.

[22]  H. Kelman,et al.  Assessment of Maternal Health Care Quality: Conceptual and Methodologic Issues , 1975, Medical care.

[23]  K. Grimmer-Somers,et al.  Number and frequency of physiotherapy services for motor vehicle-induced whiplash: interrogating motor accident insurance data 2006-2009. , 2012, Journal of rehabilitation medicine.

[24]  T. Greenhalgh,et al.  Realist review - a new method of systematic review designed for complex policy interventions , 2005, Journal of health services research & policy.

[25]  Rebecca Tooher,et al.  Extending an evidence hierarchy to include topics other than treatment: revising the Australian 'levels of evidence' , 2009, BMC medical research methodology.

[26]  Jerod M Loeb,et al.  The current state of performance measurement in health care. , 2004, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[27]  M. Roland,et al.  Defining quality of care. , 2000, Social science & medicine.

[28]  Onyebuchi A Arah,et al.  A conceptual framework for the OECD Health Care Quality Indicators Project. , 2006, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[29]  L. Zwelling,et al.  Strategic Service Quality Management for Health Care , 1996, American journal of medical quality : the official journal of the American College of Medical Quality.

[30]  Brian H Rowe,et al.  Prioritizing performance measurement for emergency department care: consensus on evidence-based quality of care indicators. , 2011, CJEM.

[31]  A. Donabedian,et al.  The quality of care. How can it be assessed? , 1988, JAMA.

[32]  Jenkins Rg,et al.  Preventive services in the primary care practices of the Practice Partner Research Network. , 2000 .

[33]  David Pencheon,et al.  Developing a sustainable health and care system: lessons for research and policy , 2013, Journal of health services research & policy.

[34]  Kampan Mukherjee,et al.  Performance measurement system for healthcare processes , 2007 .

[35]  Sheila Leatherman,et al.  The OECD Health Care Quality Indicators Project: history and background. , 2006, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[36]  M. Chassin,et al.  The urgent need to improve health care quality. Institute of Medicine National Roundtable on Health Care Quality. , 1998, JAMA.

[37]  Marije Bosch,et al.  Public Reporting in Health Care: How Do Consumers Use Quality-of-Care Information?: A Systematic Review , 2009, Medical care.

[38]  Afschin Gandjour,et al.  An Evidence‐Based Evaluation of Quality and Efficiency Indicators , 2002, Quality management in health care.

[39]  D. B. Smith.  The measurement of health care quality: a problem in psychological scaling and social decision theory. , 1972, Social science & medicine.

[40]  V. Kazandjian,et al.  Safety is part of quality: a proposal for a continuum in performance measurement. , 2008, Journal of evaluation in clinical practice.

[41]  Donald M Berwick,et al.  All-or-none measurement raises the bar on performance. , 2006, JAMA.

[42]  Martin Marshall,et al.  OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion. , 2006, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[43]  K. Grimmer-Somers,et al.  Who Uses Physiotherapy Services for Motor Vehicle-Induced Whiplash-Associated Disorders? Interrogating Motor Accident Insurance Data for 2006-2009 , 2011 .

[44]  A. Bialocerkowski,et al.  Application of current research evidence to clinical physiotherapy practice. , 2004, Journal of allied health.

[45]  J. Mainz.  Defining and classifying clinical indicators for quality improvement. , 2003, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[46]  A. Donabedian.  The quality of care. How can it be assessed? , 1988, JAMA.

[47]  D. Altman,et al.  Driving up the Quality and Relevance of Research Through the Use of Agreed Core Outcomes , 2012, Journal of health services research & policy.

[48]  M. T. J. Buñuales,et al.  La clasificación internacional del funcionamiento de la discapacidad y de la salud (CIF) 2001 , 2002 .

[49]  D. Fay,et al.  Getting the most out of multidisciplinary teams: A multi-sample study of team innovation in health care , 2006 .

[50]  A. Donabedian,et al.  Promoting Quality through Evaluating the Process of Patient Care , 1968 .

[51]  M. Bardsley.  Understanding patterns of complex care: Putting the pieces together , 2012, Journal of health services research & policy.

[52]  Jeffrey Braithwaite,et al.  CareTrack: assessing the appropriateness of health care delivery in Australia , 2012, The Medical journal of Australia.