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Open Access Study protocol

Developing a patient and family-centred approach for measuring the quality of injury care: a study protocol

Henry T Stelfox12347*, Jamie M Boyd3, Sharon E Straus5 and Anna R Gagliardi6

Author affiliations

1 Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary Zone, Canada

2 Department of Medicine, University of Calgary and Alberta Health Services, Calgary Zone, Canada

3 Department of Community Health Sciences, University of Calgary, Calgary, Canada

4 Institute for Public Health, University of Calgary, Calgary, Canada

5 Saint Michael’s Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada

6 University Health Network, Toronto, ON, Canada

7 Teaching Research & Wellness Building, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada

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Citation and License

BMC Health Services Research 2013, 13:31  doi:10.1186/1472-6963-13-31

Published: 27 January 2013

Abstract

Background

Quality indicators (QI) are used in health care to measure quality of service and performance improvement. Health care professionals and organizations caring for patients with injuries need information regarding the quality of care provided and the outcomes experienced in order to target improvement efforts. However, very little is known about the quality of injury care provided to individual patients and populations and even less about patients’ perspectives on quality of care. The absence of QIs that incorporate patient or family preferences, needs or values has been identified as an important gap in the science and practice of injury quality improvement. The primary objective of this research protocol is to develop and evaluate the first set of patient and family-centred QIs of injury care for critically injured patients

Methods/design

This mixed methods study is comprised of three Sub-Studies. Sub-Study A will utilize focus group methodology to describe the preferences, needs and values of critically injured patients and their family members regarding the quality of health care delivered. Qualitative content analysis of the transcripts will begin after the first completed focus group and will draw on grounded theory using a process of open, axial and selective coding. A panel of stakeholders will be assembled during Sub-Study B to review the themes identified from the focus groups and develop a catalogue of potential patient and family-centred QIs of injury care using the RAND/UCLA Appropriateness Method (RAM). The QIs developed by the stakeholder panel will be pilot tested in Sub-Study C using surveys of patients and their family members to determine construct validity, intra-rater reliability and clinical sensibility.

Discussion

Measuring the quality of injury care is but a first step towards improving patient outcomes. This research will develop the first set of patient and family-centred QIs of injury care. To improve patient care, we need accessible, reliable indicators of quality that are important to patients, and that can then be used to establish quality of care benchmarks, to flag potential problems or successes, follow trends over time and identify disparities across organizations, communities, populations and regions.

Keywords:
Injury; Patient-centred care; Quality improvement; Quality indicators; Trauma; Focus group; Consensus panel; Survey