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Table 4 Generalised Decision Matrix (quantitative scores in median, qualitative comments:  = positive, ± = neutral, − = negative, green shaded = highest score on criterion)

From: A framework to improve quality of hospital-based physiotherapy: a design-based research study

Scores on a scale of 1 to 5:

1 = very inappropriate

2 = inappropriate

3 = sufficiently appropriate

4 = appropriate

5 = very appropriate

Criterion 1: Measurable (an essential and distinguishing attribute: discriminatory power)

Criterion 2: Acceptable (adequate to satisfy a need, requirement or standard: safety, acceptance)

Criterion 3: Impact (to have a strong effect on quality: focused and efficient)

Criterion 4: Accessible (easy to understand and use: cost, effort)

Method 1:

Continuing Education

Median Score: 4,0

Score: 3

± Number of courses is measurable, but doubts about discriminatory power

- Measurable to what extent someone has taken it, not what someone has learned from it

Score: 4

This will be acceptable for everyone

- If you have to make certain development according to departmental plan, possibly not acceptable

Score: 4

± If it also concerns non-physiotherapeutic skills, such as PDCA

± Training is the 1st step, implementation/application the 2nd step

- This does not give a good impression of the quality (attendance obligation versus result obligation)

Score: 4

± Low effort, high cost

± Costs are manageable at team level

- Dependent on departmental budget

Method 2:

Feedback PREMs and PROMs

Median Score: 4,0

Score: 5

If PREMS and PROMS are collected per person or per department, this can be easily measurable

Score: 3

± In team with a “just-culture” acceptable

± Does require guidance and explanation

- This can produce confrontational data

Score: 5

± This is very focused, gives a good picture. Can take a lot of effort to retrieve this data.

± Easy and targeted, condition is a good set of prems and proms

Score: 3

± Does require some effort and decisiveness from a department

- Set-up can entail a lot of effort/work and a lot of costs

Method 3:

Quality portfolio

Median Score: 4,0

Score: 5

If knowledge and skills for quality portfolio are tested annually, this can be easily measured

Score: 4

When knowledge and skills are in good order, this may not be a problem

Score: 4

Experience shows that this works well and uncovers gaps in knowledge and skills

Easy and fast to apply

Score: 3

Little effort, little cost

Method 4:

Peer Observation & Feedback

Median Score: 4,0

Score: 4

Requires uniform application

± If this is done using rubrics, this can be easily measured

- More qualitative by nature

Score: 3

Can also promote a culture of feedback and dialogue

In team with a “just-culture” acceptable. Also, acceptable if you manage security well (e.g., anonymously)

± Requires explanation and experience

- Can be threatening to have a look behind the scenes

Score: 5

± Very direct and efficient way

Peer Feedback is often considered to be very valuable, especially when adding a feedback course

Easy to use and targeted

Score: 4

± Little cost, some effort

- Team leader must be the driving force, is a risk for success

Method 5:

360 degree feedback

Median Score 3,0

Score: 3

- The degree to which someone is willing to ask for feedback has a great influence on the result

- More qualitative by nature

- Requires training, experience: colleagues have difficulties with this

Score: 3

± In team with “just-culture” acceptable

± Dependent on free choice in this

- Not everyone will find it convenient to collect feedback

Score: 4

Is multidisciplinary feedback (only valuable alongside peer feedback)

± Provided it is performed well

- Pleasing each other can distort

Score: 4

± Little cost, some effort

- Difficult to complete, difficult to ask whom to ask

Method 6:

Management Information System

Median Score: 4,5

Score: 5

Pre-eminently measurable matters

Establish the Critical Process Indicators as a team and include them in the annual development discussion

- What are those Critical Process Indicators?

Score: 4

This data is already being collected

± It is a little unclear which Critical Process Indicators are involved; this is a determining factor for this criterion

Score: 3

Agreements are recorded

± Difficult to estimate

- Says little about quality

Score: 5

Is already there, no cost, no effort

± Difficult to estimate

Method 7:

Intervision with intercollegiate Evaluation

Median Score: 4,0

Score: 3

± Whether measurable depends on methodology/score form

± Provided it is carried out properly

- More qualitative by nature

Score: 4

Accepted working method

After some experience

- This can be experienced as threatening

Score: 5

Very direct and efficient way

Score: 4

Easy to fit in

± Little cost, but effort