Measurement and improvement of human services

The measure of quality of organizations in the healthcare system, such as h ospitals or nursing homes, is multidimensional and complex. Frequently impl emented indicators of quality in other areas of trade and industry cannot, therefore, be Simply imported as appropriate indicators of process and outc ome quality in health care. To quote one example, most health organizations are dependent on varied stakeholders which might include patients, health insurance companies, and state-owned establishments. The interests of all i nvolved have to be incorporated in the quality measurement system. in the p roject described here, the Productivity Measurement and Enhancement System (ProMES; Pritchard, Kleinbeck & Schmidt, 1993) has been succesfully tested as a method for measuring quality on two wards of a psychiatric hospital in Germany. The participants involved comprised members of different professi ons. i.e., nurses, physicians, and social workers, on that ward. For the pa rticipants, especially the clarification of the common tasks of the group a nd the precise definition of accepted standards of quality - requirements w ithin system development - were described as quite helpful for their work C ontrary to doubts expressed by many participants at the start of the Projec t, it was possible to develop content valid indicators: the necessary data for evaluation could also be easily collected by the groups. It turned out that the development and application of the system also helped the groups t o identify and solve problems in the organization of their work. Aiming to get more groups working with their own ProMES systems, further employees fr om the hospital are now being trained to develop systems with colleagues fr om other wards.