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MARQuIS - Methods of Assessing Response to Quality Improvement Strategies MARQuIS: WP4: The Questionnaire Niek Klazinga Kiki Lombarts Ines Rupp.

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Presentation on theme: "MARQuIS - Methods of Assessing Response to Quality Improvement Strategies MARQuIS: WP4: The Questionnaire Niek Klazinga Kiki Lombarts Ines Rupp."— Presentation transcript:

1 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies MARQuIS: WP4: The Questionnaire Niek Klazinga Kiki Lombarts Ines Rupp

2 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Objectives The strategic objective of work package 4 is to describe in a sample of EU member states how hospitals have applied national quality strategies, to what extend they meet the defined requirements of cross-border patient care and what organizational and/or methodological variables are associated with (non-)compliance of requirements. Further, WP4 is to validate the statistical results provided by WP3 concerning types and quantity of health services used by patients from another European member state.

3 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies WP 4: Questionnaire Purpose measure quality improvement: the application of Q policies and procedures, Q governance structure as well as Q activities, used to close the gap between current and expected levels of quality measure quality: quantifying the current levels of performance or compliance with expected requirements.

4 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Three main phases 1.Defining a concrete set of measures (development of a questionnaire) to identify quality strategies in hospitals and quality requirement for hospital care delivered to EU cross-border patients 2.Collecting data through a questionnaire survey in an ad random sample of hospitals in 8 EU member states 3.Analysing and reporting the data

5 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Focus of the questionnaire in measuring quality (improvement) in hospitals

6 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Section S1S2S3S4 Number of questions63424846 Number of itemsappr. 500 in total Questionnaire Design

7 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Recruitment & response Hospitals visiting quest. Hospitals responded UK4114 Ireland2925 Neth1210 Belgium3325 France10078 Spain131113 Poland8480 Czech Rep5344 Total483389

8 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Challenges for analyses Frequency distribution answers Testing of hypotheses Contributing to the audit tool Developing a QI-maturity classification for sampling for the audit testing of hypotheses

9 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies QI-maturity classification Policy, planning, documents20 itemsα=0.86 Leadership36 itemsα=0.89 Structure19 itemsα=0.69 QI activities8 itemsα=0.75 QI activities (labs)20 itemsα=0.85 Patient involvement 6 itemsα=0.82 Accountability 4 itemsα=0.54 → scores combined in an overall classification score

10 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Hospital response Hospitals in overall QI classification Belgium2524 Czech Republic4438 France7865 Ireland2523 The Netherlands10 8 Poland8076 Spain113105 UK1410 Total389349 Response QI-maturity classification

11 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Variance overall classification score min.max. Belgium (n=24)2.10 -3.10 Czech Republic (n=38)1.50 -3.00 France (n=65)1.87 -3.25 Ireland (n=23)1.90 -3.08 The Netherlands (n=8)2.09 -2.52 Poland (n=76)1.86 -3.45 Spain (n=105)1.70 -3.26 UK (n=10)1.77 -2.37 Total (n=349)1.50 -3.45

12 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Hospital distribution per country based on the classification score Belgium 316 5 Czech Republic1022 6 France113222 Ireland 812 3 The Netherlands 4 4 - Poland223321 Spain205530 UK 9 1 - Total8717587 *most mature: ≤25e percentile; least mature: > 75e percentile (entire sample) “least mature” * “most mature” *

13 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies WP 5: Hospital audits On-site hospital audits Verify questionnaire responses Obtain details of quality methods 105 hospitals, 8 countries Recruiting hospitals that have returned WP4 questionnaire Sample based on QI-maturity classification (most / least mature) Belgium 6, Czech Republic 15, France 21, Ireland 8, The Netherlands 4, Poland 15, Spain 30, United Kingdom 6

14 MARQuIS - Methods of Assessing Response to Quality Improvement Strategies Further validation QI- maturity classification Reliability study Consistency over dimensions Exploring the “QI-index” in other datasets (e.g., PATH) Validity study Comparison with maturity classification based on audit Linking to data on accreditation / performance indicators (e.g. France, Spain)


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