An evaluation of audiology service improvement documentation in England using the chronic care model and content analysis

Abstract

Objective: Implementation of the chronic care model (CCM) is associated with improved outcomes for patients. It follows that any proposed policy or implementation plan that maps highly onto the CCM is more likely to lead to improved outcomes. The aim of this study was to compare long-term condition (LTC) policy documents and audiology quality standard documents with the CCM and to highlight the need for further research in service implementation and clinical outcome. Design: We carried out a keyword-in-context content analysis of relevant documents. Study sample: Documents relating to health department policy on LTCs, audiology service improvement initiatives in England and the CCM. Results: This analysis shows that current audiology implementation documents in England map poorly onto the CCM compared to health policy documents relating to the management of LTCs. The biggest discrepancies occur in self-management support, delivery system design, and decision support. These elements are supported by the best evidence of potential improvements in clinical outcome. Conclusions: Our content analysis of audiology service quality improvement documents in England suggests they compare poorly to some elements of the CCM. We discuss the implications this might have for future research.

Key Words::

• Service improvement
• implementation
• policy
• long term condition
• chronic care model
• content analysis

Acknowledgements

The authors wish to thank Adam Beckman and Pauline Smith for their comments and insight during the design phase of the study and for providing feedback during preparation of the manuscript.

Declaration of interest: The authors declare that there are no conflicts of interest. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.