Page 120 - Shared Guideline Development Experiences in Fertility Care

Chapter 6
Abstract
Study question: What value can patients add to the development of guideline- based quality indicators for patient-centredness in fertility care?
Summary answer: Infertile patients mainly select di erent indicators and value di erent dimensions of patient-centredness (e.g. information and communication and access to care) than professionals (e.g. coordination and integration of care) during an indicator development process.
What is known already: Patient-centredness is an important dimension for the quality of fertility care. However, this dimension is not adequately evaluated by professionals, due to a lack of quality indicators. Furthermore, it is suggested that patients select di erent indicators for patient-centredness than professionals, although exact di erences are unknown.
Study design, size and duration: e RAND-modi ed Delphi method (a two- step systematic consensus method) was used to develop two sets of quality indicators for patient-centredness. Similarities and di erences in the indicators as well as in aspects of patient-centredness between patients’ and professionals’ sets of indicators were analysed descriptively.
Participants, setting, methods: e development of quality indicators for patient- centredness was based on the national multidisciplinary Network Guideline on infertility. Two panels participated: One patients’ panel (n=19) and one multidisciplinary professionals’ panel (n=15).
Main results and the role of chance: From 119 formulated potential indicators of patient-centredness, the patients’ panel selected a representative set of 16, while the professionals’ panel selected 18. Five indicators were included in both sets. ese regarded the need to: perform IUI at least 6 days a week; report on treatment outcomes and complications; report on results of semen analyses in a standardized way; counsel infertile couples about the positive e ects on their chance of pregnancy of the elimination of a harmful lifestyle and provide information on the negative consequences for achieving a pregnancy in case of a high BMI. Both patients and professionals put highest value on potential indicators of information and communication in fertility care. Patients also emphasized accessibility of care, whereas professionals emphasized coordination and integration as important quality measures for patient-centredness in fertility care.
Limitations, reasons for caution: First, the total number of developed indicators in the nal set is relatively large (n=29), which could be a rst potential limitation in
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