Vanneste Dirk, De Almeida Mello Johanna, Macq Jean, Van Audenhove Chantal, Declercq Anja
Lucas, Center for Care Research and Consultancy, Katholieke Universiteit Leuven, Leuven, Belgium.
Ecole de Santé Publique, Institut de Recherche Santé et Société, Université Catholique de Louvain, Brussels, Belgium.
PLoS One. 2015 Apr 13;10(4):e0123760. doi: 10.1371/journal.pone.0123760. eCollection 2015.
The chronic diseases, comorbidities and rapidly changing needs of frail older persons increase the complexity of caregiving. A comprehensive, systematic and structured collection of data on the status of the frail older person is presumed to be essential in facilitating decision-making and thus improving the quality of care provided. However, the way in which an assessment is completed has a substantial impact on the quality and value of the results. This study examines the online completion of interRAI Home Care assessments, the possible causes for incomplete assessments and the consequences of these factors with respect to the quality of care received. Our findings indicate high nurse engagement and poor physician participation. We also observed the poor completion of items in predominantly medically- oriented sections characterized by, first, the fact that the assessors felt incapable of answering certain questions, second, the absence of required data or of a competent person to fill out the data, and third, the lack of tools necessary for essential measurements. The incompleteness of assessments has a clear negative influence on outcome generation. Moreover, without the added value of support outcomes, the improvement of care quality can be impeded and information technology can easily be seen as burdensome by the assessors. We have observed that multidisciplinary cooperation is an important prerequisite to establishing high-quality assessments aimed at improving the quality of care.
慢性病、合并症以及体弱老年人迅速变化的需求增加了护理的复杂性。全面、系统且结构化地收集体弱老年人的状况数据被认为对于促进决策从而提高所提供的护理质量至关重要。然而，评估的完成方式对结果的质量和价值有重大影响。本研究考察了interRAI家庭护理评估的在线完成情况、评估不完整的可能原因以及这些因素对所接受护理质量的影响。我们的研究结果表明护士参与度高但医生参与度低。我们还观察到以医学为主导的部分项目完成情况较差，其特征在于，首先，评估人员觉得无法回答某些问题；其次，缺少所需数据或没有合适的人来填写数据；第三，缺乏基本测量所需的工具。评估的不完整性对结果生成有明显的负面影响。此外，没有支持性结果的附加价值，护理质量的提高可能会受到阻碍，并且信息技术很容易被评估人员视为负担。我们观察到多学科合作是建立旨在提高护理质量的高质量评估的重要前提。
