Understanding the client and family experience of neuropsychological evaluation

Background: Neuropsychological evaluation serves a number of health-related purposes, but little is known about how the evaluation process is experienced by clients and their family members. In this article, we describe a quality improvement initiative that utilized a mixed-methods approach to explore personal goal attainment and satisfaction by clients and family members engaging in the evaluation process. Methods: We retrospectively reviewed data collected over a 5-year period from a neuropsychological evaluation service at a tertiary geriatric care center. At the outset of the evaluation, 492 clients and family members identified goals to better understand the client's cognition and to obtain recommendations for managing cognitive changes; the large majority of these goals were rated as achieved by the end of the feedback session. Results: At service completion, 657 clients and family members completed satisfaction questionnaires, and over 90% of respondents endorsed the highest level of satisfaction. Qualitative content analysis identified clinician behaviors, quality of care, and environmental factors as important aspects of the client and family experience. Findings were used to improve the delivery of client-centered, evidence-based care. Conclusion: The results of this initiative demonstrate the feasibility and utility of incorporating client and family goals and feedback into routine clinical practice. Practical suggestions and relevant tools are provided to assist the professional psychologist in implementing quality improvement processes in their own practices.