SRF039: Improving Quality of Dementia Care: Insights from Audit and Feedback in Primary Healthcare Practices in Ontario, Canada
Melanie Le Berre, MSc; Geneviève Arsenault-Lapierre, PhD; Laura Rojas-Rozo, MD, MSc; Isabelle Vedel, MD, PhD; Carrie McAiney, PhD; Jennifer Ingram, MD, FRCPC
Objective: To discuss primary healthcare practices experiences after the implementation of dementia care models and future needs for improving practice using an audit and feedback approach.
Human Subjects Review: Approved by the University of Waterloo Office of Research Ethics.
Design: Audit and feedback approach. Audit component included data from: a) chart review of dementia patients, b) validated questionnaires on dementia knowledge, attitudes and practice for clinicians and c) semi-structured interviews with clinicians. For the feedback component, data was presented at the sites followed by focus groups which were analyzed with deductive content and inductive thematic analysis.
Setting: Eight purposefully sampled primary healthcare practices in Ontario that had implemented dementia care models. The focus groups were conducted with 63 participants including clinicians (physicians, nurses, occupational therapists, among others), managers (coordinators, administrators, receptionists) and decision makers (executive director, clinical program manager).
Intervention/Instrument: Four specific questions were discussed during the audit and feedback a) which results did you find useful/interesting/expected/surprising? b) what are the key elements that explain these results? c) what changes in terms of results would you like to see when this evaluation is performed in the future? and d) what would help your site to achieve these changes/goals?
Preliminary Results: Most reactions revolved around chart review results, specifically those on physician activities (cognitive testing, prescriptions, and referrals to memory clinics). Participants explained their results based on the model implemented (organizational factors and clinician factors). Future areas for improvement were also discussed.
Conclusion: The results of this audit and feedback study have the potential of changing and improving dementia primary care in the participating sites, as well as informing ongoing and future policies on dementia care.