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Selecting process quality indicators for the integrated care of vulnerable older adults affected by cognitive impairment or dementia.

https://arctichealth.org/en/permalink/ahliterature160072
Source
BMC Health Serv Res. 2007;7:195
Publication Type
Article
Date
2007
Author
Edeltraut Kröger
André Tourigny
Diane Morin
Lise Côté
Marie-Jeanne Kergoat
Paule Lebel
Line Robichaud
Shirley Imbeault
Solange Proulx
Zohra Benounissa
Author Affiliation
Laval University Geriatrics Research Unit, Hôpital du Saint-Sacrement, Quebec, Canada. edeltraut.kroger.cha@ssss.gouv.qc.ca
Source
BMC Health Serv Res. 2007;7:195
Date
2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cognition Disorders - diagnosis - epidemiology - therapy
Consensus
Delivery of Health Care, Integrated - standards
Delphi Technique
Dementia - diagnosis - epidemiology - therapy
Feasibility Studies
Female
Frail Elderly
Geriatric Assessment
Health Services for the Aged - organization & administration - standards
Humans
Male
Medicine - organization & administration - standards
Outcome Assessment (Health Care)
Process Assessment (Health Care)
Quality Indicators, Health Care
Quebec
Specialization
Abstract
This study aimed at evaluating face and content validity, feasibility and reliability of process quality indicators developed previously in the United States or other countries. The indicators can be used to evaluate care and services for vulnerable older adults affected by cognitive impairment or dementia within an integrated service system in Quebec, Canada.
A total of 33 clinical experts from three major urban centres in Quebec formed a panel representing two medical specialties (family medicine, geriatrics) and seven health or social services specialties (nursing, occupational therapy, psychology, neuropsychology, pharmacy, nutrition, social work), from primary or secondary levels of care, including long-term care. A modified version of the RAND(R)/University of California at Los Angeles (UCLA) appropriateness method, a two-round Delphi panel, was used to assess face and content validity of process quality indicators. The appropriateness of indicators was evaluated according to a) agreement of the panel with three criteria, defined as a median rating of 7-9 on a nine-point rating scale, and b) agreement among panellists, judged by the statistical measure of the interpercentile range adjusted for symmetry. Feasibility of quality assessment and reliability of appropriate indicators were then evaluated within a pilot study on 29 patients affected by cognitive impairment or dementia. For measurable indicators the inter-observer reliability was calculated with the Kappa statistic.
Initially, 82 indicators for care of vulnerable older adults with cognitive impairment or dementia were submitted to the panellists. Of those, 72 (88%) were accepted after two rounds. Among 29 patients for whom medical files of the preceding two years were evaluated, 63 (88%) of these indicators were considered applicable at least once, for at least one patient. Only 22 indicators were considered applicable at least once for ten or more out of 29 patients. Four indicators could be measured with the help of a validated questionnaire on patient satisfaction. Inter-observer reliability was moderate (Kappa = 0.57).
A multidisciplinary panel of experts judged a large majority of the initial indicators valid for use in integrated care systems for vulnerable older adults in Quebec, Canada. Most of these indicators can be measured using patient files or patient or caregiver interviews and reliability of assessment from patient-files is moderate.
Notes
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PubMed ID
18047668 View in PubMed
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Seniors' views on the use of electronic health records.

https://arctichealth.org/en/permalink/ahliterature174052
Source
Inform Prim Care. 2005;13(2):125-33
Publication Type
Article
Date
2005
Author
Diane Morin
Andre Tourigny
Daniel Pelletier
Line Robichaud
Luc Mathieu
Aline Vézina
Lucie Bonin
Martin Buteau
Author Affiliation
Faculty of Nursing Sciences, Université Laval, Quebec, Province of Quebec, Canada. diane.morin@fsi.ulaval.ca
Source
Inform Prim Care. 2005;13(2):125-33
Date
2005
Language
English
Publication Type
Article
Keywords
Aged
Attitude to Computers
Computer Security
Confidentiality
Data Collection
Delivery of Health Care, Integrated - organization & administration
Female
Frail Elderly
Humans
Male
Medical Records Systems, Computerized
National Health Programs
Patients - psychology
Quebec
Trust
Abstract
In the Mauricie and Centre-du-Québec region of the province of Quebec, Canada, an integrated services network has been implemented for frail seniors. It combines three of the best practices in the field of integrated services, namely: single-entry point, case management and personalized care plan. A shared interdisciplinary electronic health record (EHR) system was set up in 1998. A consensus on the relevance of using EHRs is growing in Quebec, in Canada and around the world. However, technology has out-paced interest in the notions of confidentiality, informed consent and the impact perceived by the clientele. This study specifically examines how frail seniors perceive these issues related to an EHR. The conceptual framework is inspired by the DeLone and McLean model whose main attributes are: system quality, information quality, utilisation modes and the impact on organisations and individuals. This last attribute is the focus of this study, which is a descriptive with quantitative and qualitative component. Thirty seniors were surveyed. Positive information they provided falls under three headings: (i) being better informed; (ii) trust and consideration for professionals; and (iii) appreciation of innovation. The opinions of the seniors are generally favourable regarding the use of computers and the EHR in their presence. Improvements in EHR systems for seniors can be encouraged.
PubMed ID
15992497 View in PubMed
Less detail

[The tele-surveillance as a tool to favour social participation of elderly at home].

https://arctichealth.org/en/permalink/ahliterature164177
Source
Can J Aging. 2007;26(1):59-72
Publication Type
Article
Date
2007
Author
Mathieu Garceau
Claude Vincent
Line Robichaud
Author Affiliation
Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Hamel Est, Québec. salutgoglu@hotmail.com
Source
Can J Aging. 2007;26(1):59-72
Date
2007
Language
French
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Aging
Focus Groups - methods
Frail Elderly
Home Care Services - organization & administration
Humans
Interpersonal Relations
Middle Aged
Quality of Life
Quebec
Questionnaires
Remote Consultation
Abstract
Little is known as yet about the impact of telesurveillance services on social participation. To document the interaction between telesurveillance services and social participation of the elderly living at home, a study was conducted in the context of a government call center employing nurses. A focus group study was realized with elders (n = 4), caregivers (n = 6), healthcare system practitioners and industry employees (n = 7). A qualitative analysis was performed using the Disability Creation Process model and generally accepted criteria for evaluating telehealth interventions. The results showed, on the one hand, factors that facilitate the use of telesurveillance services (user's intellectual capabilities, acceptance of clinical settings, relevance of recommendations, cost of service, and accessibility) and, on the other, factors that reinforce such use (user behaviors; level of satisfaction; impact on informal caregiver; system's level of performance; technical features; and life-habit aspects such as personal transportation, sleep, housekeeping, personal care, interpersonal relationships, and recreational activities).
PubMed ID
17430805 View in PubMed
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