Inpatients’ experiences with interdisciplinary treatment for substance dependence: Measurement, quality indicators and use of results

Abstract

The increasing focus on the openness of results and outcomes from health services as well as the quality of care that patients receive has led to increased initiatives for assessing and reporting the quality of health care as well as monitoring quality improvement initiatives. The overall aims of this thesis were to validate a questionnaire used in national cross-sectional surveys among patients receiving residential treatment for substance dependence in Norway, to test the data material gathered via these surveys for use as quality indicators and to follow employees’ reported use of these results in local quality-improvement work. Survey data based on paper and online questionnaires from four years among patients and employees were explored. The exploratory factor analyses with data from the 2013 patient-experience survey resulted in three scales: “treatment and personnel” with 12 items, “milieu” and “outcome” with five items each. The intraclass correlation coefficient for the patient-reported experience scales was 2.3% for the “treatment and personnel” scale, 8.1% for “milieu” and 4.8% for “outcome”. The employees reported generally positive attitudes towards patient-experience surveys, and 40–50% of them had implemented quality initiatives based on the results of the patient surveys. The analyses of survey data demonstrated the good psychometric properties of the patient questionnaire. When adjusted for a specific set of variables, the three scales comprising the patient questionnaire functioned well as patient-experience-based quality indicators, and employees’ reported use of the results suggests that patient-experience surveys are viewed as useful and valuable tools in quality improvement.