Kane R A, Kane R L, Illston L H, Eustis N N
Institute for Health Services Research, University of Minnesota, Minneapolis 55455.
Health Care Financ Rev. 1994 Fall;16(1):69-89.
Home care quality assurance (QA) must consider features inherent in home care, including: multiple goals, limited provider control, and unique family roles. Successive panels of stakeholders were asked to rate the importance of selected home care outcomes. Most highly rated outcomes were freedom from exploitation, satisfaction with care, physical safety, affordability, and physical functioning. Panelists preferred outcome indicators to process and structure, and all groups emphasized "enabling" criteria. Themes highlighted included: interpersonal components of care; normalizing life for clientele; balancing quality of life with safety; developing flexible, negotiated care plans; mechanisms for accountability and case management. These themes were formulated differently according to the stakeholders' role. Providers preferred intermediate outcomes, akin to process.
家庭护理质量保证（QA）必须考虑家庭护理所固有的特征，包括：多个目标、提供者控制有限以及独特的家庭角色。连续几批利益相关者被要求对选定的家庭护理结果的重要性进行评分。评分最高的结果是免受剥削、对护理的满意度、身体安全、可承受性和身体功能。小组成员更喜欢结果指标而非过程和结构指标，并且所有群体都强调“赋能”标准。突出的主题包括：护理的人际组成部分；使客户的生活正常化；在生活质量与安全之间取得平衡；制定灵活的、协商一致的护理计划；问责机制和病例管理。这些主题根据利益相关者的角色而有不同的表述。提供者更喜欢类似于过程的中间结果。
