Is it possible to measure what truly matters? The paradox of clinical audit in developing continence service standards for older people.

Brown, Patrick R. and Billings, Jenny R. and Wagg, Adrian and Potter, Jonathan (2010) Is it possible to measure what truly matters? The paradox of clinical audit in developing continence service standards for older people. The Patient: Patient-Centered Outcomes Research, 3 (1). pp. 11-23. (The full text of this publication is not available from this repository)

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Official URL
http://dx.doi.org/10.2165/11318800-000000000-00000

Abstract

Background: Standards, benchmarking, and audits are integral to quality monitoring in health and social service provision. Recent policy in the UK National Health Service dictating the need for increased consumer involvement necessitates that service users have significant input into the composition of standards for quality of care. Objective: To report the authors' recent involvement in research towards developing a set of agreed, measureable statements regarding quality in the provision of continence services using the views of older service users. Methods: This article focuses on the third of a three-stage project to involve, identify, and incorporate the views of older continence service users in the development of standards of care in continence services. Whereas stage 1 developed a questionnaire with the assistance of service users, and stage 2 piloted this as a postal survey in two contrasting areas, stage 3 applied the tool in the context of face-to-face interviews with more vulnerable older people. The approach also included open-ended questions to elicit qualitative data around experiences of continence service provision. Results: Earlier stages of the project involved the relatively unproblematic construction of standards based on views given by experts and focus groups of older people. However, more in-depth, semi-structured interviews with service users brought to light the holistic, complex, and subjective way in which the sample viewed their experiences. Conclusions: This study raises a number of questions over the efficacy of simple statements in capturing what is important to service users. If such standards are to empower patients usefully and assist professionals informatively in their provision of high-quality care, greater effort and sophistication is needed to truly reflect the needs and interests of service users. Alongside these concerns, however, there are potential ways of bridging the gap between standard setting and the lived patient experience.

Item Type: Article
Uncontrolled keywords: Health-care-services; Organisation-and-administration; Quality-of-health-care; Urinary-incontinence, treatment
Subjects: H Social Sciences > HJ Public Finance
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC952 Geriatrics
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 06 Sep 2010 15:03
Last Modified: 15 Apr 2014 13:19
Resource URI: http://kar.kent.ac.uk/id/eprint/24802 (The current URI for this page, for reference purposes)
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