Development and validation of the RQC: a daily contact log for ACT and ICM teams

Abstract

Aim– Instruments to measure the process - the daily activities of home care workers - have received little attention and may impede research in refining the active ingredients, the clientele best served and continuous quality improvement. We developed a decade ago in Quebec, Canada, a new daily contact log (relevé quotidien des contacts or RQC) that has now reached in practice 1 million entries.Methods– Three features distinguish the RQC development, namely, practical ergonomics, a clear logic, and response categories easy to understand and retain. The instrument is filled following any 10-minute or more contact with or about the client, and covers the location, time and actors of the episode of care, and the nature of the intervention (crisis, representing, accompanying, discussing) in 10 areas (i.e. medication, daily living activities, housing, relationships, substance abuse, legal, etc.). Inter-rater agreement for eachRQCresponse category and rater agreement with a criterion measure (coded vignettes) were evaluated.Results– Kappa coefficients and intra-class correlation coefficients yielded results ranging from at least moderate to generally substantial agreement for all 77 response categories.Conclusions– The newRQCmay support international studies of the implementation and application of various forms of intensive home care, refining its indications, and serves as a clinical and managerial tool to ensure quality of the interventions.Declaration of Interest:The study was financed by funds from the Fonds de la recherche en santé du Québec (FRSQ) and the Canadian Institutes of Health Research (CIHR). The authors have not been involved with any other forms of financing that might be considered a conflict of interest in connection with the submitted article.Declaration of Interest:The study was financed by funds from the Fonds de la recherche en santé du Québec (FRSQ) and the Canadian Institutes of Health Research (CIHR). The authors have not been involved with any other forms of financing that might be considered a conflict of interest in connection with the submitted article.

Effects of an assertive community program in patients with severe mental disorders and impact on their families

“…Analyses of the role of interventions in patients' outcome, as assessed by the RQC, 8 did not bring notable results, beyond descriptive data. This could relate to the small sample size included in this kind of analysis, but also to a chicken‐and‐egg causality dilemma: interventions are likely to improve patients' conditions, yet at the same time patients with multiple and resistant problems are more likely to get a higher amount of sustained attention.…”

“…The activities of clinicians with patients and their families were measured with a daily contact log, the Relevé Quotidien des Contacts (RQC), 8 which covers the location, time and actors involved in the episode of care and the nature of the intervention (crisis, representing, accompanying, discussing) in 10 areas (i.e. medication, daily living activities, housing, relationships, substance abuse, legal, etc.…”

“…Third, the nature and number of mobile interventions needed to influence patients' outcomes remain to be established 8 …”