Feedback to professionals on patient-centered fertility care is insufficient for improvement: a mixed-method study
SourceFertility and Sterility, 99, 5, (2013), pp. 1419-1427
Article / Letter to editor
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Fertility and Sterility
SubjectNCEBP 12: Human Reproduction; NCEBP 4: Quality of hospital and integrated care; NCEBP 12: Human Reproduction
OBJECTIVE: To determine the effect of audits and feedback on the level of patient-centeredness in fertility care, and to obtain a more in-depth understanding of professionals' views on patient-centered care and achieving improvements. DESIGN: Mixed-method design, using semistructured in-depth interviews and patient questionnaires. SETTING: Fifteen Dutch fertility clinics. PATIENT(S): Women in infertility treatment (quantitative section) and fertility care professionals (qualitative section). INTERVENTION(S): Audit of the level of patient-centeredness of care, and feedback provided to clinics by a personalized paper-based feedback report. MAIN OUTCOME MEASURE(S): Quantitative section: the patient-reported differences in the level of patient-centered fertility care between 2009 and 2011 measured by the Patient-Centeredness Questionnaire-Infertility. Qualitative section: professionals views on improving patient-centered fertility care arranged into a Hibbard framework for behavioral change. RESULT(S): Multilevel regression analysis showed no statistically significant differences between the overall levels of patient-centeredness in 2009 and 2011. Qualitative research showed that professionals' urge to change and their ability to translate feedback were suboptimal to achieve behavioral change. CONCLUSION(S): Audits and feedback alone are not enough to improve the level of patient-centeredness in fertility care. Increasing professionals' desire to change and their ability to translate feedback about their performance into an optimal quality improvement strategy appear to be the key issues.
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