Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention

Marjo Je Campmans-Kuijpers, Lidwien C Lemmens, C.A. Baan, Guy Ehm Rutten

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: 

More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention.

Methods: 

This before-after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization's quality management program. Patient-centeredness (0%-100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients' access to medical files, patient education policy, safeguarding patients' interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests.

Results: 

Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002), and on its subdomains "access to medical files" (from 42.0% to 49.4%), and "safeguarding patients' interests" (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P=0.54) or its subdomains. "Formal patient involvement" remained low in both care groups (23.2%) and outpatient clinics (33.9%).

Conclusion: 

After a simple intervention, care groups significantly improved their quality management on patient-centeredness, but outpatient clinics did not. Interventions to improve quality management on patient-centeredness in diabetes care organizations should differ between primary and secondary care.

Original languageEnglish
Pages (from-to)1957-1966
JournalPatient preference and adherence
Volume10
DOIs
Publication statusPublished - 2016

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quality management
chronic illness
Organizations
outpatient clinic
Ambulatory Care Facilities
Group
Patient Participation
manager
Benchmarking
questionnaire
telephone
Type 2 Diabetes Mellitus

Cite this

Campmans-Kuijpers, Marjo Je ; Lemmens, Lidwien C ; Baan, C.A. ; Rutten, Guy Ehm. / Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention. In: Patient preference and adherence. 2016 ; Vol. 10. pp. 1957-1966.
@article{6c2e7d0ea821473a9f6bbbdcf37c958b,
title = "Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention",
abstract = "Background: More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention.Methods: This before-after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization's quality management program. Patient-centeredness (0{\%}-100{\%}) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients' access to medical files, patient education policy, safeguarding patients' interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests.Results: Care groups improved significantly on patient-centeredness (from 47.1{\%} to 53.3{\%}; P=0.002), and on its subdomains {"}access to medical files{"} (from 42.0{\%} to 49.4{\%}), and {"}safeguarding patients' interests{"} (from 58.1{\%} to 66.2{\%}). Outpatient clinics, which scored higher at baseline (66.7{\%}) than care groups, did not improve on patient-centeredness (65.6{\%}: P=0.54) or its subdomains. {"}Formal patient involvement{"} remained low in both care groups (23.2{\%}) and outpatient clinics (33.9{\%}).Conclusion: After a simple intervention, care groups significantly improved their quality management on patient-centeredness, but outpatient clinics did not. Interventions to improve quality management on patient-centeredness in diabetes care organizations should differ between primary and secondary care.",
author = "Campmans-Kuijpers, {Marjo Je} and Lemmens, {Lidwien C} and C.A. Baan and Rutten, {Guy Ehm}",
year = "2016",
doi = "10.2147/PPA.S117388",
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pages = "1957--1966",
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Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention. / Campmans-Kuijpers, Marjo Je; Lemmens, Lidwien C; Baan, C.A.; Rutten, Guy Ehm.

In: Patient preference and adherence, Vol. 10, 2016, p. 1957-1966.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention

AU - Campmans-Kuijpers, Marjo Je

AU - Lemmens, Lidwien C

AU - Baan, C.A.

AU - Rutten, Guy Ehm

PY - 2016

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N2 - Background: More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention.Methods: This before-after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization's quality management program. Patient-centeredness (0%-100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients' access to medical files, patient education policy, safeguarding patients' interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests.Results: Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002), and on its subdomains "access to medical files" (from 42.0% to 49.4%), and "safeguarding patients' interests" (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P=0.54) or its subdomains. "Formal patient involvement" remained low in both care groups (23.2%) and outpatient clinics (33.9%).Conclusion: After a simple intervention, care groups significantly improved their quality management on patient-centeredness, but outpatient clinics did not. Interventions to improve quality management on patient-centeredness in diabetes care organizations should differ between primary and secondary care.

AB - Background: More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention.Methods: This before-after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization's quality management program. Patient-centeredness (0%-100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients' access to medical files, patient education policy, safeguarding patients' interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests.Results: Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002), and on its subdomains "access to medical files" (from 42.0% to 49.4%), and "safeguarding patients' interests" (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P=0.54) or its subdomains. "Formal patient involvement" remained low in both care groups (23.2%) and outpatient clinics (33.9%).Conclusion: After a simple intervention, care groups significantly improved their quality management on patient-centeredness, but outpatient clinics did not. Interventions to improve quality management on patient-centeredness in diabetes care organizations should differ between primary and secondary care.

U2 - 10.2147/PPA.S117388

DO - 10.2147/PPA.S117388

M3 - Article

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