The University of Southampton
University of Southampton Institutional Repository

It just didn’t work: the realities of quality assessment in the English health care context

It just didn’t work: the realities of quality assessment in the English health care context
It just didn’t work: the realities of quality assessment in the English health care context
Aims: Assessment of care quality is integral to health and palliative care provision and there is a need to develop and implement outcome measures to assess quality. This study aimed to: (1) describe the implementation of a palliative care outcome measure in non-specialist palliative care settings and (2) to understand the implementation of the measure.
Method: Twenty-five non-specialist palliative care settings were purposely sampled and invited to implement a palliative care outcome measure. Fifteen settings agreed to take part. The research team provided training and support in the use of the measure. Data were collected on actual use of the measure and, via interviews with patients and nurses, on their experiences.
Results: The number of assessments was low (21 patients assessed against an anticipated minimum of 240). The analysis of nurses’ accounts identified important considerations in understanding the low response. Although nurses saw the implementation of the outcome measure as bringing opportunities for themselves, including their own professional development, and for the organisations they represent, including raising organisational profiles, there were a number of factors that acted as impediments. These include: perceived time to administer the paperwork; competence and confidence in recruiting patients and proceeding with informed consent; concerns about the effects of completing the measure with very ill patients; and the effects of nurses raising palliative care issues on their relationships with patients.
Conclusions: It is difficult to integrate outcome measures into routine clinical practice. Future interventions should consider how to tailor the implementation of outcome measures within existing working structures and provide education and training to enable nurses to deal with potentially sensitive palliative care issues.
quality, audit, outcome, palliative care, research
0020-7489
705-712
Hughes, R.
938ac53c-edfb-4b20-b99b-31e2cbd18768
Aspinall, F.
626e053c-a256-4ba1-87ee-f70838afa376
Addington-Hall, J.M.
87560cc4-7562-4f9b-b908-81f3b603fdd8
Dunckley, M.
1ea4fc8f-b8b6-4ff5-858c-6abda1215410
Faull, C.
e1541bc6-3cbb-4320-baa2-baec342c2b0a
Higginson, I.
2174d6b0-f13e-44ed-b6f6-6ae7142d9a4a
Hughes, R.
938ac53c-edfb-4b20-b99b-31e2cbd18768
Aspinall, F.
626e053c-a256-4ba1-87ee-f70838afa376
Addington-Hall, J.M.
87560cc4-7562-4f9b-b908-81f3b603fdd8
Dunckley, M.
1ea4fc8f-b8b6-4ff5-858c-6abda1215410
Faull, C.
e1541bc6-3cbb-4320-baa2-baec342c2b0a
Higginson, I.
2174d6b0-f13e-44ed-b6f6-6ae7142d9a4a

Hughes, R., Aspinall, F., Addington-Hall, J.M., Dunckley, M., Faull, C. and Higginson, I. (2004) It just didn’t work: the realities of quality assessment in the English health care context. International Journal of Nursing Studies, 41 (7), 705-712. (doi:10.1016/j.ijnurstu.2004.02.005).

Record type: Article

Abstract

Aims: Assessment of care quality is integral to health and palliative care provision and there is a need to develop and implement outcome measures to assess quality. This study aimed to: (1) describe the implementation of a palliative care outcome measure in non-specialist palliative care settings and (2) to understand the implementation of the measure.
Method: Twenty-five non-specialist palliative care settings were purposely sampled and invited to implement a palliative care outcome measure. Fifteen settings agreed to take part. The research team provided training and support in the use of the measure. Data were collected on actual use of the measure and, via interviews with patients and nurses, on their experiences.
Results: The number of assessments was low (21 patients assessed against an anticipated minimum of 240). The analysis of nurses’ accounts identified important considerations in understanding the low response. Although nurses saw the implementation of the outcome measure as bringing opportunities for themselves, including their own professional development, and for the organisations they represent, including raising organisational profiles, there were a number of factors that acted as impediments. These include: perceived time to administer the paperwork; competence and confidence in recruiting patients and proceeding with informed consent; concerns about the effects of completing the measure with very ill patients; and the effects of nurses raising palliative care issues on their relationships with patients.
Conclusions: It is difficult to integrate outcome measures into routine clinical practice. Future interventions should consider how to tailor the implementation of outcome measures within existing working structures and provide education and training to enable nurses to deal with potentially sensitive palliative care issues.

This record has no associated files available for download.

More information

Published date: 2004
Keywords: quality, audit, outcome, palliative care, research

Identifiers

Local EPrints ID: 9798
URI: http://eprints.soton.ac.uk/id/eprint/9798
ISSN: 0020-7489
PURE UUID: 73112e17-481d-417f-9023-06a0084eae1c

Catalogue record

Date deposited: 23 Oct 2004
Last modified: 15 Mar 2024 04:57

Export record

Altmetrics

Contributors

Author: R. Hughes
Author: F. Aspinall
Author: M. Dunckley
Author: C. Faull
Author: I. Higginson

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×