Applicability of the ReproQ client experiences questionnaire for quality improvement in maternity care

Scheerhagen, Marisja; Stel, Henk F. van; Tholhuijsen, Dominique J.C.; Birnie, Erwin; Franx, Arie; Bonsel, Gouke J.

doi:10.7717/peerj.2092

“…Although with a different purpose, another experience questionnaire in perinatal care reached a 32% response rate. 21 Compared to this questionnaire, the PCB sets' PROMs and…”

Section: Discussionmentioning

confidence: 99%

A feasibility study of implementing a patient‐centered outcome set for pregnancy and childbirth

Depla

¹

,

Ernst-Smelt

²

,

Poels

³

et al. 2020

Health Science Reports

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Background and Aims Patient‐reported outcome and experience measures (PROM and PREM) can facilitate shared decision making and hold potential to improve healthcare quality. However, their adoption in perinatal care is still limited. The International Consortium for Health Outcomes Measurement (ICHOM) developed a Pregnancy and Childbirth (PCB) outcome set, including PROM and PREM questionnaires. We studied the feasibility to use these PROMs/PREMs in Dutch perinatal care, addressing both women's and professionals' perspective. Methods Patients and professionals in primary and hospital care participated. Women under care at one of five timepoints for PROM/PREM collection of the PCB set (2 during pregnancy, 3 postpartum) were e‐mailed a questionnaire and discussed their answers with their obstetric professional the next regular visit. Compliance was recorded. After discussing the PROMs/PREMs, usability and experience were assessed with separate surveys amongst women and professionals. Results Of 26 women approached, 21 completed and discussed their PROM/PREM questionnaire. Mean questionnaire completion rate was 97%. Average reported time completing the questionnaires was 10 minutes; most women (90%) stated this was acceptable. Women preferred completing questionnaires digitally and discuss their answers with an obstetric professional rather than other care professionals, also 6 months postpartum. Over half of women agreed PROMs/PREMs supported shared decision making (58%), ability to raise issues (60%), and patient‐clinician relationship (52%). Six professionals participated: two obstetricians, two clinical midwives, and two community midwives. Most professionals experienced sufficient time to discuss the responses, except at 6 months postpartum. They knew what items to discuss but did not always feel responsible to act upon them. Professionals agreed PROMs/PREMs supported symptom detection and personalized care. Conclusions Patients and obstetric professionals consider the PCB set a feasible instrument for PROM/PREM assessment, with good compliance, acceptability and usability. Important determinants of successful implementation are a well‐equipped ICT‐tool, agreements regarding professionals' responsibilities and how outcomes are discussed or acted upon.

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“…In that case, differences across units truly are small, causing low ICCs and lack of discrimination. We believe that favorable antenatal performance should be interpreted primarily as uniform performance rather than good performance (Scheerhagen et al 2015b;Scheerhagen et al 2016). This phenomenon has been described with other client experience questionnaires as well (Peterson et al 2005 Manuscript to be reviewed suboptimal ReproQ domain and item scores and recommend actions for improvement.…”

Section: Discussionmentioning

confidence: 79%

“…Psychometric analyses support the content and construct validity as well as the testretest reliability of the questionnaire (Scheerhagen et al 2015b;Scheerhagen et al 2016). For the remainder of this paper, we will only present the results of the 2 nd half of pregnancy, as the ratings of the 1 st and 2 nd half of the pregnancy are highly associated (ICC=0.83) (Scheerhagen et al 2018).…”

Section: Introductionmentioning

confidence: 69%

Peer Review #3 of "The discriminative power of the ReproQ: a client experience questionnaire in maternity care (v0.1)"

2019

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Background. Aim of the ReproQuestionnaire (ReproQ) is to measure the client's experience with maternity care, following WHO's responsiveness model. To support quality improvement, ReproQ should be able to discriminate best from worst organisational units. Methods. We sent questionnaires to 27,487 third-trimester pregnant women (response 31%) and to 37,230 women 6 weeks after childbirth (response 39%). For analysis we first summarized the ReproQ domain scores into three summary scores: total score (all eight domains), personal score (four personal domains), and setting score (four setting domains). Second, we estimated the proportion of variance across perinatal units attributable to the 'actual' difference across perinatal units using intraclass correlation coefficients (ICCs). Third, we assessed the ability of ReproQ to discriminate between perinatal units based on both a statistical approach using multilevel regression analyses, and a relevance approach based on the minimally important difference (MID). Finally, we compared the domain scores of the best and underperforming units. Results. ICCs ranged between 0.004 and 0.025 for the summary scores, and between 0.002 and 0.125 for the individual domains. ReproQ was able to identify the best and worst performing units with both the statistical and relevance approach. The statistical approach was able to identify four underperforming units during childbirth (total score), while the relevance approach identified 10 underperforming units. Conclusions. ReproQ, a valid and efficient measure of client experiences in maternity care, has the ability to discriminate well across perinatal units, and is suitable for benchmarking under routine conditions.

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“…A total of 60 of 85 Dutch perinatal units participated. Further details have 153 been reported elsewhere (Scheerhagen et al 2016). 154 There were no exclusion criteria.…”

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confidence: 99%

“…Non-responding clients received a reminder two weeks after the initial 158 243 scores below a certain threshold that equals the mean score domain or summary score 244 of the 10% best performing units minus the MID. We previously determined, at the 245 individual level, the minimally important difference (MID) for both the summary and 246 domain scores of the childbirth period (Scheerhagen et al 2016). For the study reported 247 here, we derived MIDs for the late pregnancy and postnatal reference periods in a 248 similar way.…”

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confidence: 99%

Peer Review #2 of "The discriminative power of the ReproQ: a client experience questionnaire in maternity care (v0.2)"

2019

0

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Background. Aim of the ReproQuestionnaire (ReproQ) is to measure the client's experience with maternity care, following WHO's responsiveness model. To support quality improvement, ReproQ should be able to discriminate best from worst organisational units. Methods.We sent questionnaires to 27,487 third-trimester pregnant women (response 31%) and to 37,230 women 6 weeks after childbirth (response 39%). For analysis we first summarized the ReproQ domain scores into three summary scores: total score (all eight domains), personal score (four personal domains), and setting score (four setting domains). Second, we estimated the proportion of variance across perinatal units attributable to the 'actual' difference across perinatal units using intraclass correlation coefficients (ICCs). Third, we assessed the ability of ReproQ to discriminate between perinatal units based on both a statistical approach using multilevel regression analyses, and a relevance approach based on the minimally important difference (MID). Finally, we compared the domain scores of the best and underperforming units. Results. ICCs ranged between 0.004 and 0.025 for the summary scores, and between 0.002 and 0.125 for the individual domains. ReproQ was able to identify the best and worst performing units with both the statistical and relevance approach. The statistical approach was able to identify four underperforming units during childbirth (total score), while the relevance approach identified 10 underperforming units. Conclusions. ReproQ, a valid and efficient measure of client experiences in maternity care, has the ability to discriminate well across perinatal units, and is suitable for benchmarking under routine conditions. PeerJ reviewing PDF | Abstract 29 Background. Aim of the ReproQuestionnaire (ReproQ) is to measure the client's 30 experience with maternity care, following WHO's responsiveness model. To support 31 quality improvement, ReproQ should be able to discriminate best from worst 32 organisational units. 33 Methods. We sent questionnaires to 27,487 third-trimester pregnant women (response 34 31%) and to 37,230 women 6 weeks after childbirth (response 39%). For analysis we 35 first summarized the ReproQ domain scores into three summary scores: total score (all 36 eight domains), personal score (four personal domains), and setting score (four setting 37 domains). Second, we estimated the proportion of variance across perinatal units 38 attributable to the 'actual' difference across perinatal units using intraclass correlation 39 coefficients (ICCs). Third, we assessed the ability of ReproQ to discriminate between 40 perinatal units based on both a statistical approach using multilevel regression 41 analyses, and a relevance approach based on the minimally important difference (MID). 42 Finally, we compared the domain scores of the best and underperforming units. PeerJ reviewing PDF |Manuscript to be reviewed 43 Results. ICCs ranged between 0.004 and 0.025 for the summary scores, and between 44 0.002 and 0.125 for the individual doma...

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Applicability of the ReproQ client experiences questionnaire for quality improvement in maternity care

Cited by 23 publications

References 44 publications

A feasibility study of implementing a patient‐centered outcome set for pregnancy and childbirth

A feasibility study of implementing a patient‐centered outcome set for pregnancy and childbirth

Peer Review #3 of "The discriminative power of the ReproQ: a client experience questionnaire in maternity care (v0.1)"

Peer Review #2 of "The discriminative power of the ReproQ: a client experience questionnaire in maternity care (v0.2)"

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