Quality measurement of out-patient neuropsychological therapy after stroke in Germany: definition of indicators and retrospective pilot study
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Quality measurement of out-patient neuropsychological therapy after stroke in Germany: definition of indicators and retrospective pilot study. / Padberg, I; Heel, S; Thiem, P; Diebel, A; Mordhorst, E; Strohmeyer, U; Meisel, A.
In: BMC NEUROL, Vol. 21, No. 1, 17.02.2021, p. 76.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Quality measurement of out-patient neuropsychological therapy after stroke in Germany: definition of indicators and retrospective pilot study
AU - Padberg, I
AU - Heel, S
AU - Thiem, P
AU - Diebel, A
AU - Mordhorst, E
AU - Strohmeyer, U
AU - Meisel, A
PY - 2021/2/17
Y1 - 2021/2/17
N2 - BACKGROUND: In contrast to the hospital setting, today little work has been directed to the definition, measurement, and improvement of the quality of out-patient medical and therapeutic care. We developed a set of indicators to measure the quality of out-patient neuropsychological therapy after stroke.METHODS: The indicators cover core and interdisciplinary aspects of out-patient neuropsychological work such as mediation of patients into social care in case of need. Selection of the quality-indicators was done together with a consensus group of out-patient therapists and supported by evidence, validity, reliability as well as estimated relevance and variability with the quality of care. The set of indicators was further tested in a retrospective cohort study. Anonymous data of 104 patients were collected from out-patient clinical records of five clinics between November 2017 and April 2018. Associations between process and outcome quality were estimated exploitatively.RESULTS: Results allowed for the identification of areas with greater variability in the quality of process care and indicated that attention training as recommended by current guidelines had the lowest overall rate for meeting the quality-aim (met in 44% of the cases). This was followed by time < 1 month until the start of therapy (63% met) and mediation into social care in case of need (65% met). We further observed that overall quality and involving relatives in the therapy was associated with higher rates of professional reintegration (p-value = 0.03). However, the need for mediation into social care was associated with a reduced chance for successful professional reintegration (p-value = 0.009).CONCLUSION: In conclusion, we describe a first set of quality indicators which cover different aspects of out-patient neuropsychological therapy and sufficient variability with care. First data further suggests that meeting the specified quality aims may indeed have relevant effects on outcomes.
AB - BACKGROUND: In contrast to the hospital setting, today little work has been directed to the definition, measurement, and improvement of the quality of out-patient medical and therapeutic care. We developed a set of indicators to measure the quality of out-patient neuropsychological therapy after stroke.METHODS: The indicators cover core and interdisciplinary aspects of out-patient neuropsychological work such as mediation of patients into social care in case of need. Selection of the quality-indicators was done together with a consensus group of out-patient therapists and supported by evidence, validity, reliability as well as estimated relevance and variability with the quality of care. The set of indicators was further tested in a retrospective cohort study. Anonymous data of 104 patients were collected from out-patient clinical records of five clinics between November 2017 and April 2018. Associations between process and outcome quality were estimated exploitatively.RESULTS: Results allowed for the identification of areas with greater variability in the quality of process care and indicated that attention training as recommended by current guidelines had the lowest overall rate for meeting the quality-aim (met in 44% of the cases). This was followed by time < 1 month until the start of therapy (63% met) and mediation into social care in case of need (65% met). We further observed that overall quality and involving relatives in the therapy was associated with higher rates of professional reintegration (p-value = 0.03). However, the need for mediation into social care was associated with a reduced chance for successful professional reintegration (p-value = 0.009).CONCLUSION: In conclusion, we describe a first set of quality indicators which cover different aspects of out-patient neuropsychological therapy and sufficient variability with care. First data further suggests that meeting the specified quality aims may indeed have relevant effects on outcomes.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Ambulatory Care/standards
KW - Consensus
KW - Female
KW - Germany
KW - Humans
KW - Male
KW - Middle Aged
KW - Neuropsychology
KW - Outcome and Process Assessment, Health Care
KW - Pilot Projects
KW - Psychotherapy/standards
KW - Quality Indicators, Health Care
KW - Reproducibility of Results
KW - Retrospective Studies
KW - Stroke/physiopathology
KW - Stroke Rehabilitation/standards
U2 - 10.1186/s12883-021-02092-0
DO - 10.1186/s12883-021-02092-0
M3 - SCORING: Journal article
C2 - 33596841
VL - 21
SP - 76
JO - BMC NEUROL
JF - BMC NEUROL
SN - 1471-2377
IS - 1
ER -
