Construction Of Quality Evaluation Index System Of Community Hospice Care

ObjectivesTo explore the current situation of community hospice care quality evaluation,building a systematic and scientific quality evaluation index system of community hospice care based on this,so as to provide basis for standardizing the quality management of community hospice care.MethodsBy means of purposive sampling,9 medical staff engaged in hospice care of 3 community medical institutions in Jinan City,Shandong Province were choosed as the research objects,and semi-structured interviews were conducted on them.Based on the three-dimensional quality evaluation model as the basic framework,the interview data were collated and analyzed.And the initial quality evaluation index system of community hospice care was constructed in combination with the results of literature review.Two rounds of expert inquiry were conducted among 21 experts by Delphi method,forming the final quality evaluation index system of community hospice care,and through the analytic hierarchy process(AHP)and expert importance assignment average allocation method is applied in determing weights of indicators at all levels.Findings1.This study extracted two themes through qualitative interviews:the current situation of community hospice care quality evaluation and the key indicators of community hospice care quality evaluation.2.1n this study,a total of 21 experts participated in Delphi expert inquiry.After two rounds of inquiry,the expert opinions tended to be agreed.The recovery rate of the two rounds inquiry questionnaire was100%,and the proportions of expert comments were 57.14%and 28.57%indicating that the experts are highly motivated.The two rounds of expert authority coefficients were 0.879 and 0.897,showing that the authority of experts was high.The Kendall harmony coefficients of the two rounds were 0.179 and0.211,P<0.05,the difference was statistically significant,prompting that the coordination degree of expert opinions was high.After two rounds of inquiry,the mean value、coefficient of variation and full mark rate of each index all satisfy the inclusion criteria of this study.Finally,an quality evaluation index system of community hospice care was formed,which included three first-level indicators,20 secondlevel indicators and 107 third-level indicators.3.In this study,analytic hierarchy process(AHP)was used to determine the weights of the first and second level indicators.The weights of the first level indicators were:structural quality(0.1958),process quality(0.4934)and result quality(0.3108).The weights of 20 secondary indicators were:environmentand layout(0.1864),facilities(0.1071),personnel organization(0.2826),institutionalnorms(0.1413),training and test(0.2826),symptom assessment and management(0.1586),comfort care(0.0965),therapeutic nursing(0.1108),ethics and law(0.1897),psychological and spiritual care(0.1108),family and social support(0.1326),information support(0.0511),security management(0.0427),community resources(0.0784),bereavement support(0.0611),life quality(0.3543),adverse outcome(0.0779),death quality(0.2685),satisfaction evaluation(0.1877),social and economic benefits(0.1115).Applying the expert importance assignment average allocation method to determine the weight of three-level indicators,and the combination weightsof two and three-level indicators were determined by using the principle of probability multiplication.ConclusionsThis study takes the three-dimensional quality evaluation model as the theoretical framework,using literature review,qualitative interview and Delphi expert inquiry method to build community hospice care quality evaluation index system.Through the application of analytic hierarchy process and the expert importance assignment average allocation method to further determine the weight of indicators at all levels.The research method of this study is scientific and rigorous,the index content is systematic and comprehensive,which can provide a reference for objectively evaluating the quality of community hospicecare.