title: Connecting the voices of users, caregivers and providers on service quality: a study of home-care services.
abstract: OBJECTIVE
  This article aims to discuss the relevancy of different instruments used to gather information on homecare service quality from multiple stakeholders and the challenges encountered when trying to blend their views for prioritizing areas needing improvement.
  
  
  METHODS
  The study centers on four homecare agencies: one public, one private for-profit and two not-for-profit services, implementing continuous quality improvement (CQI) programs. Various instruments were tested with random and convenience elderly service user, family caregiver and front-line worker samples. Instrument evaluation included operational effectiveness and agency manageability.
  
  
  RESULTS
  A qualitative approach, centered on small stakeholder samples, is fairly effective at assessing service quality, yet demands a strong commitment from agencies in personnel time and resources, as well as the necessary skills. Small-size, private homecare providers seem less-well equipped to handle comprehensive assessments without external support More importantly, assessments have to be done strategically, such that timing and work needed does not undermine program viability.
  
  
  CONCLUSIONS
  The approach and instruments tested have practical implications for decision makers and homecare organization managers interested in CQI.
  
  
  CONCLUSIONS
  The article systematically evaluates quality assessment and priority-setting instruments applied to various stakeholders and homecare settings.
authors.affiliation: Institut de recherche en santé publique (IRSPUM), Université de Montréal, Québec, Canada. oscar.e.firbank@umontreal.ca
authors.forename: Oscar E
authors.initials: OE
authors.lastname: Firbank
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D017028:Caregivers; D003142:Communication; D003266:Continuity of Patient Care; D005260:Female; D006699:Home Care Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D058996:Quality Improvement / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data