Development of an experienced quality measure for clients, informal and formal caregivers in home care in the Netherlands: A participatory action research

Abstract

To optimise home care provision and to identify potential improvements in the care process, it is important to gain insight into the care experiences that influence care quality. The aim was to develop a qualitative experienced quality measure for home care in The Netherlands, facilitating conversations between clients and caregivers in generating possible points of improvement for the primary care process. A participatory action research design to develop the measure following three iterative cycles, using various data sources in evaluating requirements related to the goal, feasibility in care setting, and usability in the care process. The final design comprises an instruction meeting for district nurses and a structured approach to evaluate experienced quality with clients, informal caregivers, and formal caregivers. The measure encompasses cards to visually support communicating on experienced quality themes (e.g., personal needs and expectations), sub-themes (e.g., preferred way of communicating needs), exemplary questions, and a reporting sheet. The first evaluation gave indications of the measure results in formulating concrete points of improvement for the primary care process. This study indicates that the developed experienced quality measure seems promising relating to requirements for its goal, feasibility in the care setting, and usability in the care process. More insight is needed if and how improvements are communicated, documented, and followed-up in practice. In the next step, the measure should be extensively tested and evaluated in a more diverse sample (e.g., clients with dementia) for measuring experienced quality and reflecting on its outcomes.