Development of quality indicators for memory clinics

OBJECTIVE: To develop and validate a set of relevant, feasible, and reliable quality indicators (QIs) for the Memory Clinics (MCs). BACKGROUND: MCs are important care providers for people with dementia and their caregivers. A set of valid QIs is needed to incorporate evidence-based guidelines into MC clinical practice, and measure adherence to guidelines. METHODS: A total of 17 MC specialists, 12 primary care physicians; and seven informal caregivers participated in several Delphi rounds to select and validate QIs. Ten MCs participated in the indicator compliance study involving the analysis of data extracted from 100 medical records. RESULTS: The initial set of 56 single QIs was reduced to a final set of 14 indicators measuring the quality of processes, structures, and outcomes of care. The panels of representatives of MCs, primary care physicians, and informal caregivers judged overall face validity to be high. The differences in compliance rates between the three indicator types were significant (p<0.001) as were the differences between the MCs (p<0.005). The compliance measures were highest for the process indicators and lowest for the outcome indicators. CONCLUSION: The final set of 14 QIs that met the psychometric requirements can be used to facilitate the implementation of guidelines and the assessment of the quality of care offered by MCs. The QIs are acceptable for a broad range of users (specialists, referring physicians, and informal caregivers), and are capable of discriminating between MCs in terms of quality.