Quality indicators for community services

In March 2008, the Centre for Academic Primary Health Care at the University of Bristol was commissioned by the Director of Commissioning at NHS Bristol to develop quality indicators for community services. The motivation for developing quality indicators was to help staff better understand the contribution they make to patient care and to work towards developing a commissioning tool to use in contracting community services. The project had two main aims:

1. To produce a framework for developing quality indicators for Bristol Community Health services

2. To develop a set of indicators for Bristol Community Health services using the proposed framework

The framework detailed the four main steps:

Clarifying who should be involved
Selecting the conditions
Identifying potential indicators
Refining the indicators

Using this framework, we selected the district nursing service as a test case and developed 31 process and outcome indicators. Two of these were organisational, applicable across the service, and 21 related to end of life, wound and diabetes care – the three clinical areas of the greatest focus for district nurses. We also developed a patient satisfaction questionnaire for district nursing service users, which provided a further 8 potential indicators such as access to equipment, transition between services and information giving. In addition, we identified two possible tools to collect patient specified outcomes (MYMOP and Goal Attainment Scaling), which could be modified to provide additional indicators. Although designing the framework and developing the indicators has proved challenging, we have fulfilled the original brief. For further information, please see full project report (PDF, 985kB)