DEVELOPMENT AND EVALUATION OF AN INFORMATION-SYSTEM FOR QUALITY ASSURANCE

The aim of this study was to develop and evaluate an information syste m. for monitoring impact of acute hospital care on health status of el derly patients, burden on carers, and consumer satisfaction with care. The study was undertaken on four acute care wards of an elderly care unit of a teaching hospital. We used a consensus-building process to a chieve within-and-between-team convergence of policy and practice in t he use of structured assessments on three wards, with parallel data co llection by a research nurse on one ward. We describe the changes to o ur working practices, the costs of data collection, staff attitudes to the system and the assessment instruments, using 5-point Likert Scale s, with additional in-depth interviews with senior staff for their att itudes to the system. We found that only nursing staff were able to ch ange their practice. On admission, it was feasible to undertake functi onal assessment of activities of daily living (ADL), depression, perce ived life quality and carer strain. Discharge assessment was only feas ible for ADL. Other discharge assessments and follow-up assessments in cluding consumer satisfaction interviews required audit assistant supp ort. The total annual cost per ward was 6,225 Pound for the adopted sy stem, or 6,455 Pound to incorporate follow-up assessments by audit ass istant in a random sample of 50 patients. Staff attitudes to the syste m were positive, especially for use of the Relatives' Stress Scale, an d for the value of follow-up interviews. We conclude that the particip atory approach to the introduction of the information system produced a system which was perceived to be beneficial for patient care. The sy stem has potential for measuring the outcomes of care, but greater eff iciency is required before the system can be regarded as cost-effectiv e.