A multi-phase, multi-centre development and validation of two maturity tools assessing the implementation of the FlaQuM co-creation roadmap

Abstract

Background: As part of the new Flanders Quality Model (FlaQuM) towards sustainable quality management systems, a co-creation roadmap with six primary drivers and 19 building blocks that guides healthcare organisations has been developed. Currently, no assessment tool is available to monitor hospitals’ quality management systems implementation according to this co-creation roadmap. Therefore, we aimed to measure the maturity of the implementation of the FlaQuM co-creation roadmap in hospitals. Methods: A three-phase approach in co-design with 19 hospitals started with defining the scope, followed by establishing content validity through a literature review, involvement of content experts (n=47), 20 focus groups with content experts (n=79) and a Delphi round with healthcare quality managers (n=19) to test the content validity index (CVI). Construct validity was assessed by confirmatory factor analyses and convergent validity by Spearman’s ρ correlation coefficients. Results: Based on 17 included existing maturity instruments and sub-components of content experts, two maturity tools were developed according to the implementation of the FlaQuM co-creation roadmap: 1) a maturity matrix with 52 sub-components and 2) a co-creation scan with 19 statements. The overall scale-CVI varied between 93.3% and 90.0% in terms of relevance and clarity, respectively. In a sample of 119 healthcare professionals, factor analyses revealed a 6-factor structure and 16 (84.2%) of the 19 hypothesis for testing convergent validity between both maturity tools were statistically significant. Conclusion: Measuring the implementation of the FlaQuM co-creation roadmap and monitoring its maturity over time should be feasible by using these comprehensive maturity tools in hospitals. Results of both tools should be able to describe the current state of hospitals’ implementation of the co-creation roadmap as basis for strategic improvement plans and next steps.