[Developing and testing quality indicators of home care in Switzerland]

The aim of this study was to develop and examine quality indicators of home care in Switzerland using the Swiss version of the RAI-HC (Resident Assessment Instrument Home Care). The quality indicators are part of the quality management strategy of the 'Spitex Verband Schweiz', the organisation of Swiss home care institutions.

The study consisted of four steps. First, a set of potential quality indicators was operationalised. For this purpose, already defined indicators of the North American version of RAI-HC were adopted, also additional indicators based on the Swiss RAI-HC were developed. In a second step, the changeability, practicability and relevance of these quality indicators were judged by home care professionals using a group consensus method (nominal group technique). Third, based on a sample of 1808 clients from a total of 45 Swiss home care organisations, the quality indicators were empirically tested with regard to sample frequencies (incidences and prevalences) and between-group variance. Fourth, the interrater reliability of the quality indicators was assessed.

A total of 29 potential home care quality indicators was developed. Based on the results of the three sub-studies (rating by experts, frequencies/variation and interrater reliability), a core-set of 19 quality indicators was defined which can be recommended for quality measurement in home care settings of Switzerland.

The Swiss version of RAI-HC provides a viable instrument for measuring quality of home care. The application of consistent assessment rules should be improved.