Findings

Monitoring & evaluating care quality

Monitoring & evaluating care quality

What is the challenge?
  • Healthcare systems are under pressure to maintain or improve standards of care with depleting resources(a)
  • There is a lack of established quality benchmark, requiring centres to establish their own goals
  • Low quality of care may result in poor patient satisfaction and potentially impact patient outcomes(b)
Performing regular monitoring and evaluation of AD care quality at centre and amongst wider network
What is the goal/s of the intervention?
  • Ensure centres are consistently identifying and addressing areas/gaps to maintain and improve their quality of AD care
  • Streamline usage of resources through a systemic approach to evaluating care and identifying what needs improvement
  • Facilitate identification of leading industry practices and interventions through standardised metrics to assess patient care across multiple centres
  • Greater confidence felt by patients towards the care provided by AD centres
Who is often involved in the intervention?
  • Department heads/Lead physician
  • Quality manager (if present at centre)
  • Patient
  • Healthcare system
  • Physician
  • Nurse
  • Administrative staff
What are the potential outcomes?

Patients

  • Opportunity to provide input into care experience
  • Improvement in quality of care received through centre addressing areas of need
  • Greater confidence in the processes that inform the level and type of care provided

HCPs

  • Ongoing ability to identify areas of care that could be addressed to improve patient outcomes, patient satisfaction, care efficiency etc.
  • Ability to assess consistency of care delivered across HCPs

Healthcare system

  • Awareness of areas of care that could be addressed to improve patient outcomes, patient satisfaction, care efficiency etc.
  • Ensuring consistency in appropriate standards of care across centres
(a)

Understanding NHS financial pressures: How are they affecting patient care? The King’s Fund. [PDF] https://www.kingsfund.org.uk/sites/ files/kf/field/field_publication_file/Understanding%20NHS%20financial %20pressures %20-%20full%20report.pdf Accessed 5 Nov2019;

(b)

Public satisfaction with the NHS in 2015. The King’s Fund [Website] https://www.kingsfund.org.uk/publications /public-satisfaction-nhs-2015 Accessed 22 Oct 2019

What is offered as part of the intervention and how has the intervention been implemented in different centres?

Note:    With input from the steering committee, we have categorised these activities by level of resource required to implement, however this may vary across centres/settings (e.g. depending on existing resources)

EASY
  • Undertaking a manual capture and analysis of patient outcomes (e.g. via excel)
  • Defining goals of care as a team (structure, process and outcome measures) and ways to measure/capture these
    • This may involve collection of quantitative measures (e.g. scoring indices, PROs, IgE) and qualitative measures (e.g. patient satisfaction)
  • Performing patient surveys before and/or after outpatient consultations (e.g. via paper, iPad)
MEDIUM
  • Participating in cross-centre quality evaluation, involving a mail questionnaire or online survey assessing patient experiences
  • Designing a bespoke online database enabling the consistent collection and storage of patient data (e.g. EASI/SCORAD scores) in a format that can be easily analysed
  • Bringing together groups of HCPs to review patient care case studies to assess care approach
  • Designating dedicated human resource to monitor and evaluate data collection
  • Designing a dynamic process to allow for ongoing quality improvement/assessment/evaluation
ADVANCED
  • Developing a dashboard which demonstrates quality of care through integration of electronic medical records and quality indicators
  • Creating automated pop-up alerts and notifications on PCP computers when prescribing certain dermatological medication that may suggest alternative treatments and allows tracking by centre
  • Inviting external professional/body etc. to perform an external audit of service
Relevant centre case studies

Development of online patient databases

Structured patient assessment tool, UKSH (Kiel), Germany

Centre’s own biobank, UKSH (Kiel), Germany

Registry of patients with severe AD, Linkou Chang Gung Memorial Hospital (Taipei), Taiwan

Monitoring PCP prescribing

Frequent advice for primary care professionals, Harrogate District Hospital, UK

Participating in cross-centre quality evaluation/performing patient surveys

Clinical internal audits, UMC Utrecht, Netherlands

Monitoring and evaluating care quality

Monitoring patient quality of care, KFMC, Saudi Arabia