Department of Medicine, University of Ottawa, Canada.
Ottawa Hospital Research Institute, The Ottawa Hospital, Canada.
J Telemed Telecare. 2022 May;28(4):280-290. doi: 10.1177/1357633X21998216. Epub 2021 Mar 3.
High-quality correspondence between healthcare providers is critical for effective patient care. We developed an assessment tool to measure the quality of specialist correspondence to primary care providers (PCPs) via electronic consultation (eConsult), where specialists provide advice without specialist-patient interactions. We incorporated fourteen previously described features of high-quality eConsult correspondence into an assessment tool named the eConsult Specialist Quality of Response (eSQUARE). Six PCPs and two specialists applied the 10-item eSQUARE tool to 30 eConsults of varying quality as informed by PCP survey data. Content, response process, and internal structure validity evidence was gathered. Psychometric properties were calculated using descriptive statistics and generalizability analyses. Mean total score for low-quality eConsults (M = 24 ± 5.6) was significantly lower than moderate-quality eConsults (M = 38 ± 4.7; p<0.001) which was significantly lower than high-quality eConsults (M = 46 ± 3.0; p = 0.002). Reliability measures were high, including generalizability coefficient (0.96), inter-item (≥0.55) and item-total correlations (≥0.68). A decision study demonstrated that a single rater was adequate to achieve a reliability measure of ≥0.70. This study demonstrates initial validity evidence including multiple reliability measures for the eSQUARE. A single rater is adequate to achieve reliability measures for formative feedback. Future studies can apply the eSQUARE when planning educational initiatives aiming to improve specialist-to-PCP correspondence via eConsult.
医疗保健提供者之间的高质量沟通对于有效的患者护理至关重要。我们开发了一种评估工具，通过电子咨询（eConsult）来衡量专家与初级保健提供者（PCP）之间的专业通信质量，在这种咨询中，专家在没有专家-患者互动的情况下提供建议。我们将之前描述的 14 项高质量电子咨询通信特征纳入名为电子咨询专家响应质量（eSQUARE）的评估工具中。六名 PCP 和两名专家根据 PCP 调查数据，使用 10 项 eSQUARE 工具对 30 份质量不同的 eConsult 进行评估。收集了内容、响应过程和内部结构有效性证据。使用描述性统计和可概括性分析计算心理测量学特性。低质量 eConsults 的平均总分（M=24±5.6）明显低于中等质量 eConsults（M=38±4.7；p<0.001），而高质量 eConsults（M=46±3.0；p=0.002）则明显高于中等质量 eConsults。可靠性测量值较高，包括可概括性系数（0.96）、内部一致性（≥0.55）和项目-总分相关性（≥0.68）。决策研究表明，单个评分者足以达到≥0.70 的可靠性测量值。本研究证明了 eSQUARE 的初步有效性证据，包括多种可靠性测量值。单个评分者足以达到形成性反馈的可靠性测量值。未来的研究可以在规划旨在通过电子咨询改善专家与 PCP 之间的通信的教育计划时应用 eSQUARE。
