gms | German Medical Science

Background: Measurement of patient-centredness of care is becoming increasingly popular. The first step is to define optimal patient-centred quality, not only by doctors and in terms of outcome measurements (live born rates per cycle), but also by patients.

Objective: To develop and compare two sets (by professionals and patients) of guideline-based patient-centered quality indicators for fertility care.

Methods: The RAND-modified Delphi method was used to develop two sets of quality indicators, based on a Dutch multidisciplinary guideline on infertility. Two expert panels were used: 15 different professionals involved in fertility care (e.g., gynaecologists, urologists, general practitioners.) and 19 infertile patients.

Results: Of 102 potential guideline-based indicators, professionals selected a representative set of 11 patient-centred indicators. Patients selected fifteen patient-centred indicators. Professionals predominantly chose indicators regarding the general practitioners’ role (e.g., playing an active role in improving lifestyle); patients emphasized the gynaecologists’ role (informing the general practitioner regularly). Both sets included informational and organisational aspects of care. Professionals valued emotional support (possibility to discuss emotional aspects) and respect for patients’ values for monitoring fertility care. Patients valued physical comfort, accessibility and continuity of care (alignment between different disciplines).

Discussion: This study describes the systematic development of patient-centred quality indicators for fertility care. Patients were able to appraise potential quality indicators regarding the patient-centredness of fertility care and clearly selected different indicators than professionals.

Implications for users: This study is the first step in broadening the monitoring of reproductive healthcare and reinforces the importance of involving all relevant stakeholders, including patients.