In this post, I would like to cover defining quality of care and how it could be measured to enable better planning and delivery.
Drawing from recent examples, the following pointers, in my opinion are important characteristics of quality care.
At the National Irish Homecare conference, Tony O'Brien CEO HSE presented on the the importance of combining a person centered and an integrated care approach to provide better social care services.
The nine components encompass a full spectrum, from prevention/proactive measures through to high dependency measures.
Professor David Oliver as one of the report's authors in a post in support of the The King's Fund report emphasised the importance of
- Ending "..the silos that place prevention and public health, long-term conditions, acute care, intermediate care, long-term care and end-of-life care in separate plans and pathways..."
- Moving "..away from a constant focus on organisations and who is providing care, and look instead at components of care – older, frail people or those with multiple complex co-morbidities, including dementia, will not have the same needs as younger or less medically complex patients..."
In essence, quality care includes a care programme (of different therapies/disciplines) that is appropriate for the person and their local context.
There can be different perspectives on appropriate measures ranging from criteria specified in local healthcare and administration policies to national policies such as the Adult Social Care Outcomes framework which include specific older care related measures.
From my own research, I see two categories;
- Lifestyle related measures which focus on typical daily activities that provide a good barometer of an older person's quality of life such as ability to make a cup of tea or walk a distance unaided
- Healthcare related measures focusing on the operation of the healthcare system such as number of hospital discharges returning to community based care, or number of people with reduced risk factors
As with the selection of any metrics to measure quality, they need to be carefully selected so that they provide an objective and thorough analysis that demonstrates impacts on the older community. Rather than influencing policies and practices that 'satisfy' the metrics, but have no overall practical benefit for the older community.
As ever, I would appreciate any comments from people on their experiences with quality of older care and their thoughts in relation to this post.