Shield T, Campbell S, Rogers A, Worrall A, Chew-Graham C, Gask L
National Primary Care Research and Development Centre, University of Manchester, UK.
Qual Saf Health Care. 2003 Apr;12(2):100-6. doi: 10.1136/qhc.12.2.100.
To identify a generic set of face valid quality indicators for primary care mental health services which reflect a multi-stakeholder perspective and can be used for facilitating quality improvement.
Modified two-round postal Delphi questionnaire.
Geographical spread across Great Britain.
One hundred and fifteen panellists representing 11 different stakeholder groups within primary care mental health services (clinical psychologist, health and social care commissioner, community psychiatric nurse, counsellor, general practitioner, practice nurse/district nurse/health visitor, psychiatrist, social worker, carer, patient and voluntary organisations).
Face validity (median rating of 8 or 9 on a nine point scale with agreement by all panels) for assessing quality of care.
A maximum of 334 indicators were rated by panels in the second round; 26% were rated valid by all panels. These indicators were categorised into 21 aspects of care, 11 relating to general practices and 10 relating to health authorities or primary care groups/trusts. There was variation in the total number of indicators rated valid across the different panels. Overall, GPs rated the lowest number of indicators as valid (41%, n=138) and carers rated the highest number valid (91%, n=304).
The quality indicators represent consensus among key stakeholder groups in defining quality of care within primary care mental health services. These indicators could provide a guide for primary care organisations embarking on quality improvement initiatives in mental health care when addressing national targets and standards relating to primary care set out in the National Service Framework for Mental Health for England. Although many of the indicators relate to parochial issues in UK service delivery, the methodology used in the development of the indicators could be applied in other settings to produce locally relevant indicators.
确定一套通用的、具有表面效度的基层医疗心理健康服务质量指标，这些指标应反映多利益相关方的观点，并可用于促进质量改进。
改良的两轮邮寄德尔菲问卷。
覆盖英国各地。
115名小组成员，代表基层医疗心理健康服务中的11个不同利益相关方群体（临床心理学家、健康和社会护理专员、社区精神科护士、咨询师、全科医生、执业护士/地区护士/健康访视员、精神科医生、社会工作者、护理人员、患者和志愿组织）。
用于评估护理质量的表面效度（在九点量表上中位数评分为8或9，且所有小组达成一致）。
第二轮中各小组对最多334项指标进行了评分；26%的指标被所有小组评为有效。这些指标被归类为21个护理方面，其中11个与全科医疗有关，10个与卫生当局或基层医疗团体/信托有关。不同小组评定为有效的指标总数存在差异。总体而言，全科医生评定为有效的指标数量最少（41%，n = 138），护理人员评定为有效的指标数量最多（91%，n = 304）。
这些质量指标代表了关键利益相关方群体在界定基层医疗心理健康服务护理质量方面的共识。当英格兰心理健康国家服务框架中规定的基层医疗相关国家目标和标准时，这些指标可为开展心理健康护理质量改进举措的基层医疗组织提供指导。尽管许多指标与英国服务提供中的局部问题相关，但指标制定过程中使用的方法可应用于其他环境，以产生与当地相关的指标。
