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Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components

BACKGROUND: Primary care-based memory clinics (PCMCs) have been established in several jurisdictions to improve the care for persons with Alzheimer’s disease and related dementias. We sought to identify key quality indicators (QIs), quality improvement mechanisms, and potential barriers and facilita...

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Autores principales: Heckman, George A., Boscart, Veronique M., Franco, Bryan B., Hillier, Loretta, Crutchlow, Lauren, Lee, Linda, Molnar, Frank, Seitz, Dallas, Stolee, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Canadian Geriatrics Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178859/
https://www.ncbi.nlm.nih.gov/pubmed/28050221
http://dx.doi.org/10.5770/cgj.19.233
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author Heckman, George A.
Boscart, Veronique M.
Franco, Bryan B.
Hillier, Loretta
Crutchlow, Lauren
Lee, Linda
Molnar, Frank
Seitz, Dallas
Stolee, Paul
author_facet Heckman, George A.
Boscart, Veronique M.
Franco, Bryan B.
Hillier, Loretta
Crutchlow, Lauren
Lee, Linda
Molnar, Frank
Seitz, Dallas
Stolee, Paul
author_sort Heckman, George A.
collection PubMed
description BACKGROUND: Primary care-based memory clinics (PCMCs) have been established in several jurisdictions to improve the care for persons with Alzheimer’s disease and related dementias. We sought to identify key quality indicators (QIs), quality improvement mechanisms, and potential barriers and facilitators to the establishment of a quality assurance framework for PCMCs. METHODS: We employed a Delphi approach to obtain consensus from PCMC clinicians and specialist physicians on QIs and quality improvement mechanisms. Thirty-eight candidate QIs and 19 potential quality improvement mechanisms were presented to participants in two rounds of electronic Delphi surveys. Written comments were collected and descriptively analyzed. RESULTS: The response rate for the first and second rounds were 21.3% (n = 179) and 12.8% (n = 88), respectively. The majority of respondents were physicians. Fourteen QIs remained after the consensus process. Ten quality improvement mechanisms were selected with those characterized by specialist integration, such as case discussions and mentorships, being ranked highly. Written comments revealed three major themes related to potential barriers and facilitators to quality assurance: 1) perceived importance, 2) collaboration and role clarity, and 3) implementation process. CONCLUSION: We successfully utilized a consultative process among primary and specialty providers to identify core QIs and quality improvement mechanisms for PCMCs. Identified quality improvement mechanisms highlight desire for multi-modal education. System integration and closer integration between PCMCs and specialists were emphasized as essential for the provision of high-quality dementia care in community settings.
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spelling pubmed-51788592017-01-03 Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components Heckman, George A. Boscart, Veronique M. Franco, Bryan B. Hillier, Loretta Crutchlow, Lauren Lee, Linda Molnar, Frank Seitz, Dallas Stolee, Paul Can Geriatr J Original Research BACKGROUND: Primary care-based memory clinics (PCMCs) have been established in several jurisdictions to improve the care for persons with Alzheimer’s disease and related dementias. We sought to identify key quality indicators (QIs), quality improvement mechanisms, and potential barriers and facilitators to the establishment of a quality assurance framework for PCMCs. METHODS: We employed a Delphi approach to obtain consensus from PCMC clinicians and specialist physicians on QIs and quality improvement mechanisms. Thirty-eight candidate QIs and 19 potential quality improvement mechanisms were presented to participants in two rounds of electronic Delphi surveys. Written comments were collected and descriptively analyzed. RESULTS: The response rate for the first and second rounds were 21.3% (n = 179) and 12.8% (n = 88), respectively. The majority of respondents were physicians. Fourteen QIs remained after the consensus process. Ten quality improvement mechanisms were selected with those characterized by specialist integration, such as case discussions and mentorships, being ranked highly. Written comments revealed three major themes related to potential barriers and facilitators to quality assurance: 1) perceived importance, 2) collaboration and role clarity, and 3) implementation process. CONCLUSION: We successfully utilized a consultative process among primary and specialty providers to identify core QIs and quality improvement mechanisms for PCMCs. Identified quality improvement mechanisms highlight desire for multi-modal education. System integration and closer integration between PCMCs and specialists were emphasized as essential for the provision of high-quality dementia care in community settings. Canadian Geriatrics Society 2016-12-23 /pmc/articles/PMC5178859/ /pubmed/28050221 http://dx.doi.org/10.5770/cgj.19.233 Text en © 2016 Author(s). Published by the Canadian Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivative license (http://creativecommons.org/licenses/by-nc-nd/2.5/ca/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited.
spellingShingle Original Research
Heckman, George A.
Boscart, Veronique M.
Franco, Bryan B.
Hillier, Loretta
Crutchlow, Lauren
Lee, Linda
Molnar, Frank
Seitz, Dallas
Stolee, Paul
Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components
title Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components
title_full Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components
title_fullStr Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components
title_full_unstemmed Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components
title_short Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components
title_sort quality of dementia care in the community: identifying key quality assurance components
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178859/
https://www.ncbi.nlm.nih.gov/pubmed/28050221
http://dx.doi.org/10.5770/cgj.19.233
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