Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd (152), 77030, Houston, TX, USA.
Department of Medicine - Health Services Research Section, Baylor College of Medicine, Houston, TX, USA.
BMC Health Serv Res. 2022 Oct 10;22(1):1243. doi: 10.1186/s12913-022-08590-2.
BACKGROUND/OBJECTIVE: Despite numerous extant measures assessing context-specific elements of care coordination, we are unaware of any comprehensive, team-based instrument that measures the requisite mechanisms and conditions required to coordinate successfully. In this study we develop and validate the psychometric properties of the Coordination Practices Survey, a context-agnostic measure of coordination for primary care teams.
Coordination items were developed based on a systematic literature review; items from previously developed scales were adapted and new items were created as needed; all items were refined after subject matter expert review and feedback. We collected data from Primary Care teams drawn from 1200 Veterans Health Administration (VHA) medical centers and outpatient clinics nationwide. 1645 primary care team members from 512 patient aligned care teams in the Veterans Health Administration completed the survey from 2015 to 2016. Psychometric properties were assessed after data collection using Cronbach's alpha, intraclass correlations and multilevel confirmatory factor analysis to assess the factor structure.
Our findings confirmed the psychometric properties of two distinguishable subscales of coordination: (a) Accountability and (b) Common Understanding. The within- and between-team latent structure of each subscale exhibited adequate fit to the data, as well as appropriately high Cronbach's alpha and intraclass correlations. There was insufficient variability in responses to the predictability subscale to properly assess its psychometric properties.
With context-specific validation, our subscales of accountability and common understanding may be used to assess coordination processes in other contexts for both research and operational applications.
背景/目的：尽管有许多现有的措施评估护理协调的特定环境要素，但我们不知道有任何全面的、基于团队的工具可以衡量成功协调所需的机制和条件。在这项研究中，我们开发并验证了协调实践调查的心理测量特性，这是一种针对初级保健团队的无上下文的协调测量工具。
协调项目是基于系统文献综述开发的；从以前开发的量表中改编了项目，并根据需要创建了新的项目；所有项目都经过主题专家审查和反馈进行了改进。我们从全国 1200 个退伍军人健康管理局（VHA）医疗中心和门诊诊所的初级保健团队收集数据。2015 年至 2016 年期间，退伍军人健康管理局的 512 个患者对齐护理团队中的 1645 名初级保健团队成员完成了调查。在数据收集后，使用 Cronbach's alpha、组内相关系数和多层次验证性因素分析评估了心理测量特性，以评估因素结构。
我们的研究结果证实了协调的两个可区分子量表的心理测量特性：（a）问责制和（b）共同理解。每个子量表的团队内和团队间潜在结构都与数据具有足够的拟合度，以及适当高的 Cronbach's alpha 和组内相关系数。可预测性子量表的响应变化不足以正确评估其心理测量特性。
经过特定于上下文的验证，我们的问责制和共同理解子量表可用于评估其他环境中的协调过程，无论是用于研究还是运营应用。
