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Quality assurance as a foundational element for an integrated system of dementia care: Perspectives from physicians and geriatricians

George A. Heckman (School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada)
Lauren Crutchlow (Schlegel Centre for Advancing Seniors Care, Conestoga College Institute of Technology and Advanced Learning, Kitchener, Canada)
Veronique Boscart (Schlegel Centre for Advancing Seniors Care, Conestoga College Institute of Technology and Advanced Learning, Kitchener, Canada)
Loretta Hillier (Geriatric Education and Research in Aging Sciences Centre, Hamilton, Canada) (Hamilton Health Sciences, Hamilton, Canada)
Bryan Franco (School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada)
Linda Lee (Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada)
Frank Molnar (Faculty of Medicine, University of Ottawa, Ottawa, Canada)
Dallas Seitz (Queen’s University, Kingston, Canada)
Paul Stolee (University of Waterloo, Waterloo, Canada)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 8 July 2019

Abstract

Purpose

Many countries are developing primary care collaborative memory clinics (PCCMCs) to address the rising challenge of dementia. Previous research suggests that quality assurance should be a foundational element of an integrated system of dementia care. The purpose of this paper is to understand physicians’ and specialists’ perspectives on such a system and identify barriers to its implementation.

Design/methodology/approach

The authors used interviews and a constructivist framework to understand the perspectives on a quality assurance framework for dementia care and barriers to its implementation from ten primary care and ten specialist physicians affiliated with PCCMCs.

Findings

Interviewees found that the framework reflects quality dementia care, though most could not relate quality assurance to clinical practice. Quality assurance was viewed as an imposition on practitioners rather than as a measure of system integration. Disparities in resources among providers were seen as barriers to quality care. Greater integration with specialists was seen as a potential quality improvement mechanism. Standardized electronic medical records were seen as important to support both quality assurance and clinical care.

Practical implications

This work identified several challenges to the implementation of a quality assurance framework to support an integrated system of dementia care. Clinicians require education to better understand quality assurance. Additional challenges include inadequate resources, a need for closer collaboration between specialists and PCCMCs, and a need for a standardized electronic medical record.

Originality/value

Greater health system integration is necessary to provide quality dementia care, and quality assurance could be considered a foundational element driving system integration.

Keywords

Citation

Heckman, G.A., Crutchlow, L., Boscart, V., Hillier, L., Franco, B., Lee, L., Molnar, F., Seitz, D. and Stolee, P. (2019), "Quality assurance as a foundational element for an integrated system of dementia care: Perspectives from physicians and geriatricians", International Journal of Health Care Quality Assurance, Vol. 32 No. 6, pp. 978-990. https://doi.org/10.1108/IJHCQA-07-2018-0187

Publisher

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Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited