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Care Coordination Measures Atlas Update

Chapter 6. Measure Maps and Profiles (continued, 11)

Measures 23-26

Measure #23. Nursing Home Work Environment and Performance Team Survey

Care Coordination Measure Mapping Table

  Measurement Perspective:
Patient/Family Health Care
Professional(s)		 System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility      
Communicate   ■  
   Interpersonal communication      
   Information transfer   ■  
Facilitate transitions      
   Across settings      
   As coordination needs change      
Assess needs and goals   ■  
Create a proactive plan of care   ■  
Monitor, follow up, and respond to change   □  
Support self-management goals      
Link to community resources      
Align resources with patient and population needs      
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination   □  
Health care home      
Care management      
Medication management      
Health IT-enabled coordination      

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Nursing Home Work Environment and Performance Team Survey

Purpose: To develop an instrument that will assess work environment and perceived work effectiveness in a nursing home facility.

Format/Data Source: Survey consists of three components of complementary nursing home attributes, including work environment and performance. Responses to the first component were based on a 5-point Likert scale. Responses to the second component were based on a 12-item Likert scale from the LEAP Survey.1

Date: Measure published in 2009.1

Perspective: Health Care Professional(s)

Measure Item Mapping:

  • Communicate:
    • Within teams of health care professionals: 1A7, 1A10, 1C8
    • Across health care teams or settings: 1C7
  • Information transfer:
    • Within teams of health care professionals: 1B12
    • Across health care teams or settings: 1B13
    • Participants not specified: 1B15, 1C2
  • Assess needs and goals: 1C8, 1D1, 1D5
  • Create a proactive plan of care: 1A10, 1B10, 1C6, 1C8
  • Monitor, follow up, and respond to change: 1C2
  • Teamwork focused on coordination: 1C4, 1D7

Development and Testing: Instrument items were adapted from a previously validated team survey in PACE programs (H. Temkin-Greener, personal communication, September 1, 2010). Reliability and construct validity were demonstrated. Two items were removed through exploratory factor analysis. Redundancy, conceptual independence, and convergent-divergent validity were assessed via Pearson correlation coefficients. Standardized Cronbach’s alphas measured internal consistency and indicated high reliability.1

Link to Outcomes or Health System Characteristics:

Logic Model/Conceptual Framework: The Shortell model was successfully adapted for a previous instrument upon which this study is related.4

Country: United States

Past or Validated Applications*:

  • Patient Age: Older Adults, Adults
  • Patient Condition: General Population/Not Condition Specific
  • Setting: Long Term Care Facility

*Based on the sources listed below.

Notes:

  • Instrument was provided by the corresponding author upon request (H. Temkin-Greener, personal communication, September 1, 2010).
  • This instrument contains 86 items. Only Section 1 was mapped, which contains 46 items; 14 of which were mapped.

Sources:

1. Temkin-Greener H, Zheng N, Katz P, et al. Measuring work environment and performance in nursing homes. Med Care 2009;47(4):482-91.
2. Temkin-Greener H, Cai S, Katz P, et al. Daily practice teams in nursing homes: Evidence from New York State. Gerontologist 2009;49(1):68-80.
3. Temkin-Greener H, Zheng NT, Shubing C, et al. Nursing home environment and organizational performance – association with deficiency citations. Med Care 2010; 48(4): 357-364.
4. Shortell S, Rousseau DM. Excerpted from The Organization and Management of Intensive Care Units [pamphlet]. 1989.

Measure #24. Measure of Processes of Care (MPOC-28)

Care Coordination Measure Mapping Table

  Measurement Perspective:
Patient/Family Health Care
Professional(s)		 System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility      
Communicate ■    
   Interpersonal communication      
   Information transfer ■    
Facilitate transitions      
   Across settings      
   As coordination needs change □    
Assess needs and goals ■    
Create a proactive plan of care □    
Monitor, follow up, and respond to change □    
Support self-management goals ■    
Link to community resources □    
Align resources with patient and population needs      
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination ■    
Health care home      
Care management      
Medication management      
Health IT-enabled coordination      

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Measure of Processes of Care (MPOC-28)

Purpose: To evaluate the quality of care during the habilitation process specific to children and adolescents.

Format/Data Source: Measurement of Processes of Care (MPOC) modified to MPOC-28 in a written survey (questionnaire). The 28-item questionnaire addresses the same 5 areas as the MPOC-20: (1) enabling and partnership, (2) general information, (3) specific information, (4) coordinated care and comprehensive care, and (5) respectful and supportive care. Habilitation is here described as, “a multifaceted service in which contributions are based on learning and experience from different areas, woven together in a complex network. Habilitation services are aimed at children with disabilities themselves, their families and at the network of people around the children. A fundamental factor in family-centered habilitation is that the interests of the child and family should guide the process both in assessing needs and in planning and carrying out the programme.”1

Date: Measure published in 2002.1

Perspective: Patient/Family

Measure Item Mapping:

  • Communicate:
    • Between health care professional(s) and patient/family: 18, 19, 24
    • Across health care teams or settings: 28
  • Information transfer:
    • Between health care professional(s) and patient/family: 6, 8, 9, 20
  • Facilitate transitions:
    • As coordination needs change: 26
  • Assess needs and goals: 2-4, 6, 19
  • Create a proactive plan of care: 10, 22
  • Monitor, follow up, and respond to change: 5, 26
  • Support self-management goals: 12-15, 27
  • Link to community resources: 11, 15
  • Teamwork focused on coordination: 22, 25, 28

Development and Testing: This instrument was developed and tested in a previous article in reference to a longer version of the instrument, MPOC-56. Construct validity and significance were demonstrated and questions were grouped via five factors: (1) enabling and partnership, (2) general information, (3) specific information, (4) coordinated and comprehensive care, and (5) respectful and supportive care. Differences were compared, applied, and addressed concerning scales between MPOCs. Test-retest reliability with Cronbach's alpha coefficients, intra-class correlation coefficients, and construct validation were all successfully demonstrated. Internal consistency was confirmed in pilot testing and beyond, while validity was supported by factor analysis.2

Link to Outcomes or Health System Characteristics: None described in the sources identified.

Logic Model/Conceptual Framework: None described in the sources identified.

Country: United States? (says Sweden in first version)

Past or Validated Applications*:

  • Patient Age: Children
  • Patient Condition: Combined Chronic Conditions, Children with Special Health Care Needs, Other – Children with Disabilities
  • Setting: Other Setting – Habilitation Departments

*Based on the sources listed below.

Notes:

  • All instrument items are located in Appendix 1 of the source article.1
  • This instrument contains 28 items; 22 were mapped.
  • 2 other versions are available: (1) MPOC-56 and (2) MPOC-20.3 Testing information on the MPOC-56 is also provided by King.2

Sources:

1. Granat T, Lagander B, Borjesson MC. Parental participation in the habilitation process: Evaluation from a user perspective. Child Care Health Dev 2002;28(6):459-67.
2. King SM, Rosenbaum PL, King GA. Parents' perceptions of care giving: development and validation of a measure of processes. Dev Med Child Neurol 1996;38:757-72.
3. McMaster University Measure of Processes of Care (MPOC) Web site. Available at: http://www.canchild.ca/en/measures/mpoc56_mpoc20.asp. Accessed: 20 September 2010.

Measure #25. Care Evaluation Scale for End-of-Life Care (CES)

Care Coordination Measure Mapping Table

  Measurement Perspective:
Patient/Family Health Care
Professional(s)		 System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility      
Communicate ■    
   Interpersonal communication      
   Information transfer      
Facilitate transitions      
   Across settings      
   As coordination needs change      
Assess needs and goals ■    
Create a proactive plan of care      
Monitor, follow up, and respond to change □    
Support self-management goals □    
Link to community resources      
Align resources with patient and population needs      
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination □    
Health care home      
Care management      
Medication management      
Health IT-enabled coordination      

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Care Evaluation Scale for End-of-Life Care (CES)

Purpose: To develop an instrument that measures the perceptions of palliative and/or end-of-life care from the perspective of the bereaved family.

Format/Data Source: 28-item questionnaire mailed to bereaved families who had a patient in palliative, end-of-life care. 10 subscales cover: (1) physical care by physicians, (2) physical care by nurses, (3) psycho-existential care, (4) help with decisionmaking for patients, (5) help with decisionmaking for family, (6) environment, (7) family burden, (8) cost, (9) availability, and (10) coordination and consistency. Responses were structured on a 6-point Likert scale.

Date: Measure published in 2004.1

Perspective: Patient/Family

Measure Item Mapping:

  • Communicate:
    • Between health care professional(s) and patient/family: 10, 11, 13-15
  • Assess needs and goals: 9, 12, 28
  • Monitor, follow up, and respond to change: 28
  • Support self-management goals: 12
  • Teamwork focused on coordination: 26, 27

Development and Testing: The CES instrument, originally 67 items, was pilot tested and revised to 28 items. Questions were developed from the Sat-Fam-IPC scale and revised after pilot testing and after receipt of written survey comments. Instrument originally in Japanese and translated through a double back-translation to English. It successfully measures aspects of palliative care and areas for improvement through demonstration of a valid Cronbach's alpha coefficient of 0.98 and an intra-class correlation coefficient in the test-retest examination of 0.57. Confirmatory factor analysis was examined and supported construct validity. Convergent and discriminant validity were calculated through correlation coefficients between the CES subscale scores and the perceived experience, yielding satisfactory results. Pearson's correlation coefficients between subscale scores established social desirability of the CES.1

Link to Outcomes or Health System Characteristics: None described in the sources identified.

Logic Model/Conceptual Framework: None described in the sources identified.

Country: United States? (says Japan in 1st version)

Past or Validated Applications*:

  • Patient Age: Not Age Specific
  • Patient Condition: Combined Chronic Conditions, Cancer/Oncology, Other – End-of-Life
  • Setting: Inpatient Facility

*Based on the source listed below and input from the measure developer.

Notes:

  • All instrument items are located in the Appendix of the source article.1
  • This instrument contains 28 items; 12 were mapped.

Sources:

1. Morita T, Hirai K, Sakaguchi Y, et al. Measuring the quality of structure and process in end-of-life care from the bereaved family perspective. J Pain Symptom Manage 2004;27(6):492-501.

Measure #26. Oncology Patients' Perceptions of the Quality of Nursing Care Scale (OPPQNCS)

Care Coordination Measure Mapping Table

  Measurement Perspective:
Patient/Family Health Care
Professional(s)		 System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility □    
Communicate ■    
   Interpersonal communication      
   Information transfer □    
Facilitate transitions      
   Across settings □    
   As coordination needs change      
Assess needs and goals ■    
Create a proactive plan of care      
Monitor, follow up, and respond to change □    
Support self-management goals □    
Link to community resources      
Align resources with patient and population needs      
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination      
Health care home      
Care management      
Medication management      
Health IT-enabled coordination      

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Oncology Patients' Perceptions of the Quality of Nursing Care Scale (OPPQNCS)

Purpose: To develop and test the Oncology Patients' Perceptions of the Quality of Nursing Care Scale (OPPQNCS).

Format/Data Source: 112 initial items within 8 subscales were developed with 59 items achieving content validity from an expert panel review and 41 items comprising the long version. The 8 subscales included: (1) professional knowledge (8 items), (2) continuity (1 item), (3) attentiveness (10 items), (4) coordination (9 items), (5) partnership (8 items), (6) individualization (9 items), (7) rapport (3 items), and (8) caring (11 items). Response provided on 4 – 6 point Likert scales.

Date: Measure published in 2003.1

Perspective: Patient/Family

Measure Item Mapping:

  • Establish accountability or negotiate responsibility: 36, 40
  • Communicate:
    • Between health care professional(s) and patient/family: 5, 25, 40
  • Information transfer:
    • Between health care professional(s) and patient/family: 34
  • Facilitate transitions:
    • Across settings: 38
  • Assess needs and goals: 17, 26, 33, 35
  • Monitor, follow up, and respond to change: 14
  • Support self-management goals: 11, 34

Development and Testing: Content validity achieved through an expert panel review. Construct validity examined using exploratory factor analysis, and internal consistency reliability determined using Cronbach's alpha coefficient. All 41 items of the long version were analyzed using PCA and promax rotation, and 40 items met all criteria. Internal consistency reliability and convergent validity were assessed for each scale. Cronbach's alpha coefficients ranged from 0.82 – 0.97. Pearson product-moment correlation coefficients demonstrate strong, positive correlations as well.2 Further testing information is available.1

Link to Outcomes or Health System Characteristics: One study concludes that patients who receive greater patient-centered nursing interventions are far more likely to exhibit desired health outcomes, which contribute to quality of life.3

Logic Model/Conceptual Framework: The Quality Health Outcomes Model (QHOM) framed the development of several studies surrounding interventions and outcomes linked to the OPPQNCS.3

Country: United States

Past or Validated Applications*:

  • Patient Age: Not Age Specific
  • Patient Condition: Combined Chronic Conditions, Cancer/Oncology, Other – End-of-Life
  • Setting: Inpatient Facility

*Based on the source listed below and input from the measure developer.

Notes:

  • All instrument items are located online.4
  • This instrument contains 41 items; 13 were mapped.
  • An OPPQNCS short version (18-items) is also available online.4

Sources:

1. Radwin LE, Alster K, Rubin KM. Development and testing of the oncology patients' perceptions of the quality of nursing care scale. Oncol Nurs Forum 2003;30(2):283-90.
2. Suhonen R, Schmidt LA, Radwin LE. Measuring individualized nursing care: Assessment of reliability and validity of three scales. J Adv Nurs 2007;59(1):77-85.
3. Radwin LE, Cabral HJ, Wilkes G. Relationships between patient-centered cancer nursing interventions and desired health outcomes in the context of the health care system. Res Nurs Health 2009;32:4-17.
4. The Oncology Patients’ Perception of the Quality of Nursing Care Scale Web site. Available at: http://www.faculty.umb.edu/laurel_radwin/oppqncs.htm Accessed: 28 April 2011.

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Publication:
14-0037-EF

Previous Publication: 11-0023-EF

Page last reviewed June 2014
Page originally created June 2014

Internet Citation: Chapter 6. Measure Maps and Profiles (continued, 11). Content last reviewed June 2014. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/es/ncepcr/care/coordination/atlas/chapter6j.html

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