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Measuring Fidelity, culture and Quality of CARe

Frans Withagen Toon van Meel. Measuring Fidelity, culture and Quality of CARe. March 2012. Why measure fidelity ?. Improve quality of care Check on implementation Study the effectivity of methods. The instrument, van Wijngaarden en Wilken (2008 ). Interviews with: 3 clients

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Measuring Fidelity, culture and Quality of CARe

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  1. Frans Withagen Toon van Meel Measuring Fidelity, culture and Quality of CARe March 2012

  2. Whymeasurefidelity? • Improvequality of care • Check onimplementation • Study the effectivity of methods

  3. The instrument, van Wijngaarden en Wilken (2008) • Interviews with: • 3 clients • 3 social workers/nurses • Team leader • CARe-instructor/coach • Optional: family and organizational level • Evaluation of 3 files

  4. Fidelitymeasurement • Auditors (training) • Internal/external • 2 days • Report team and organization

  5. Critical ingredients • The heart and the hands of the method

  6. Criticalingredients, individual level • Every client has a personal coach (social worker or nurse) who looks after his/her interests There is also at least one worker who coordinates the support on the different life domains and who guards the quality of CARe

  7. Criticalingredients, individual level • Clients experience that workers are willing to build a relationship that is based on personal encounters; that they are present, have time and pay attention; offer support and safety. The relationship is reciprocal and equal.

  8. Criticalingredients, individual level • Workers support the process of development and recovery of the client • Workers work constantly within the methodological cycle of CARe

  9. Criticalingredients, individual level • The client is enabled and stimulated to use natural resources outside the organization to participate in the community.

  10. Criticalingredients, individual level • The client is enabled and stimulated to use his/her own personal network. Those people are known to the worker who - whenever possible - makes use of the network and also offers support to the network

  11. Criticalingredients, team level 7. Workers are trained in CARe (certificate) 8. Quality is systematicly tested and improved conform the principles of rehabilitation and the working methods of CARe

  12. Criticalingredients, team level • The client’s file contains information about his recovery and rehabilitation process. The file is up to date and accessible to the client and professionals. The file contains one or more relevant and actual rehabilitation plan(s).

  13. Criticalingredients, team level 10.The team has sufficient personal and material possibilities to work with CARe in a qualitative way

  14. Results

  15. What we found • Lack of knowledge recovery proces • Not working whitin the different phases of CARe • Little use of clients’ social network • Little reflection upon the quality of work

  16. Fidelitynewversion • Criticalingredientsreduced to 6 • New developments within CARE are included

  17. Culture – what is it?? • General characteristics; things people share with one another • Part of living together, working together • Is taught • Is a relatively stable phenomenon • Function; the creation of internal cohesion and external adjustment

  18. Competing Values Framework (Quinn & Cameron, 1999). • Competing values framework shows relation between competing values; • Internal and external environment • 2. Flexibility and stability • Both competing values have been elaborated on 2 axes

  19. Culture typing (Robert E. Quinn, 1999) Flexibility and freedom of action Clan Adhocracy External orientation and differentiation Internal orientation and integration Hierarchy Market Stability and manageability

  20. Market (functionality and information flow)

  21. Clan (support)

  22. Hierarchy (respect for rules)

  23. Adhocracy (innovation)

  24. Instruments BOCI - Business Organizational Index Payne & Mansfield, 1973 OKIPO, Dullers et al, 1978, University of Leuven (Belgium) Competing Values Framework Quinn & Rohrbaugh, 1981, 1983 Thompson, McGrath & Worton, 1981 VOKIPO, De Visch, 1983, University of Leuven (Belgium) VOKIPO, De Cock et al., 1993, University of Leuven (Belgium) OCIA - Organizational Culture Assesment Instrument Quinn & Cameron 1999 FOCUS, Muijen et al., 1996, University of Leuven (Belgium) 2005

  25. Results VOKIPO Example culture measurement flexibility support innovation focused on organization focused on individual functionality and information flow respect for rules control

  26. Frans Withagen: Frans.Withagen@smo-traverse.nl • Toon van Meel: a.j.g.vanmeel@emergis.nl

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