Referring Physicians Assess the Quality of Outpatient Diagnostic Imaging Services: Development and Psychometric Evaluation of a Questionnaire

 

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Abstract

Goal In order to ensure high-quality cooperation between referring physicians and imaging services, it is important to assess the quality of imaging services as perceived by referring physicians. The present study aimed to develop and validate a questionnaire for referring physicians to assess the quality of outpatient diagnostic imaging services.

Materials & Methods The questionnaire was developed by discussing and modifying an existing instrument by the German Association of Surgeons. After qualitative pretesting, the instrument was tested with physicians referring to four outpatient diagnostic imaging services in Switzerland. The results were first assessed using descriptive statistics. The final instrument was tested for validity using the concept of known-groups validity. The hypothesis underlying this procedure was that physicians referring frequently to services estimated the quality of these services to be higher than physicians who referred less often to services. The differences in ratings were assessed using a one-sided two-sample Wilcoxon test. The final questionnaire was tested for internal consistency and reliability using Cronbach’s Alpha.

Results Results show a high level of satisfaction of referring physicians with the relevant services but also potential for quality improvement initiatives. The psychometric evaluation of the final questionnaire shows that it is a valid instrument, showing significant differences between the ratings of physicians referring with high and low frequency. Furthermore, the instrument proves to be consistent and reliable.

Conclusion The final instrument presents a valid, consistent and reliable option for assess the quality of outpatient diagnostic imaging services as perceived by referring physicians. Results can be used as a basis for quality improvement.

Key Points: 

• A newly developed questionnaire assesses the quality of outpatient diagnostic imaging services as perceived by referring physicians. The questionnaire was developed and tested in Switzerland.

• Psychometric evaluation showed the questionnaire to be a valid, consistent and reliable instrument.

• Results are of interest for imaging services as well as for initiatives encompassing several services.

Citation Format

• Jossen M, Valeri F, Heilmaier C et al. Referring Physicians Assess the Quality of Outpatient Diagnostic Imaging Services: Development and Psychometric Evaluation of a Questionnaire. Fortschr Röntgenstr 2019; 191: 725 – 731

Zusammenfassung

Ziel Um die Qualität der Kooperation zwischen Zuweisenden und Radiologie-Instituten zu verbessern, ist die Einschätzung der Qualität der erbrachten Leistung seitens der Zuweisenden essenziell. Die vorliegende Studie hat das Ziel, die Entwicklung und Validierung eines Fragebogens, mittels dessen Zuweisende die Qualität ambulanter Radiologie-Institute einschätzen, zu beschreiben.

Material & Methoden Der Fragebogen wurde auf der Grundlage eines bestehenden Instruments der Deutschen Gesellschaft für Chirurgie entwickelt, welches diskutiert und modifiziert wurde. Der neu entstandene Fragebogen wurde einem qualitativen Pre-Test unterzogen und anschließend bei Ärzten, die Patienten an ambulante Radiologie-Institute in der Schweiz zuweisen, erstmals eingesetzt. Die Resultate wurden mittels deskriptiver Statistik analysiert. Das finale Instrument wurde bezüglich seiner Validität mit dem “Known-Groups”-Konzept getestet. Diesem Verfahren unterliegt die Annahme, dass Ärzte, die häufig Patienten an ein Institut überweisen, mit diesem Institut eher zufrieden sind, als Ärzte, die selten Patienten an dieses Institut überweisen. Differenzen in der Bewertung wurden mittels eines einseitigen two-sample-Wilcoxon-Test gemessen. Das finale Instrument wurde mittels Cronbachs-Alpha bezüglich seiner internen Konsistenz und Reliabilität gemessen.

Resultate Die Resultate zeigen, dass die Zuweisenden generell sehr zufrieden sind mit der Arbeit der Radiologie-Institute, die Antworten weisen aber auch auf Verbesserungspotenzial hin. Die psychometrische Evaluation des finalen Instruments zeigt, dass dieses valide ist, da es signifikante Differenzen zwischen den Einschätzungen von häufiger und weniger häufig zuweisenden Ärzten zeigt. Zudem ist das finale Instrument konsistent und reliabel.

Schlussfolgerung Das finale Instrument ermöglicht eine valide, reliable und konsistente Überprüfung der Einschätzung der Qualität ambulanter Radiologie-Institute durch ihre Zuweisenden. Die Resultate können als Grundlage für Qualitätsverbesserungen genutzt werden.

Kernaussagen: 

• Ein neu entwickelter Fragebogen misst die Qualität ambulanter Radiologie-Institute aus der Sicht der Zuweisenden. Der Fragebogen wurde in der Schweiz entwickelt und pilotiert.

• Die psychometrische Evaluation zeigt, dass der Fragebogen valide, konsistent und reliabel ist.

• Die Resultate sind sowohl für Radiologie-Institute als auch für Initiativen, die über einzelne Institute hinausgehen, von Interesse.

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