Care Coordination Measures Atlas Update

Measures 27-30

Measure #27. Care Coordination Services in Pediatric Practices

Care Coordination Measure Mapping Table

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

Care Coordination Services in Pediatric Practices

Purpose: To assess the frequency at which pediatricians implement care coordination services in the treatment of children with special health care needs.

Format/Data Source: 8-item, self-administered, mailed survey adapted from the 1998 Medical Home Best Practices Survey developed by the Institute for Child Health Policy. Care coordination services inquired about within the survey included: (1) integrating a child's medical care plans with the care plans developed by other providers or organizations, (2) discussing a family's potential needs for non-medical services, (3) scheduling extra time for an office visit when seeing a child with special needs, (4) contacting the school about a child's health and education needs as part of care coordination, (5) meeting with the hospital discharge planning team to assist in a child's transition to the community, and (6) scheduling time with the family to discuss the results of a visit to a specialist.

Date: Measure published in 2004.¹

Perspective: Health Care Professional(s)

Measure Item Mapping:

• Communicate:
  • Information transfer:
    • Between health care professional(s) and patient/family: 6
• Facilitate transitions:
  • Across settings: 5, 7
• Assess needs and goals: 3, 8
• Create a proactive plan of care: 4
• Link to community resources: 3, 8
• Teamwork focused on coordination: 2, 3
• Care management: 2-5, 7

Development and Testing: This survey, adapted from the 1998 Medical Home Best Practices Survey developed by the Institute for Child Health Policy, was pilot tested prior to use.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

Past or Validated Applications*:

• Patient Age: Children
• Patient Condition: General Population/Not Condition Specific
• Setting: Inpatient Facility, Primary Care Facility, Other Outpatient Specialty Care Facility

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

Notes:

• Instrument items located in Table 1 of the source article.¹
• This instrument contains 8 items; 7 were mapped.

Sources:

1. Gupta VB, O'Connor KG, Quezada-Gomez C. Care coordination services in pediatric practices. Pediatrics 2004;113(5):1517-21.

Measure #28. Collaboration and Satisfaction About Care Decisions (CSACD)

Care Coordination Measure Mapping Table

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

Collaboration and Satisfaction About Care Decisions (CSACD)

Purpose: To validate an instrument developed from an earlier Decision About Transfer (DAT) instrument that measures collaboration and satisfaction about decisionmaking in patient care.

Format/Data Source: 9-item questionnaire administered to health care professionals (physicians and nurses) while they actively provide care. Using a 7-point Likert scale the instrument addresses the degree of collaboration between physicians and nurses during the decisionmaking process.

Date: Measure published in 1994.¹

Perspective: Health Care Professional(s)

Measure Item Mapping:

• Communicate:
  • Information transfer:
    • Within teams of health care professionals: 2
• Teamwork focused on coordination: 1-7

Development and Testing: The previously-constructed Decision About Transfer (DAT) instrument conferred criterion-related validity, but reliability could not be calculated for a single question, sparking development of the Collaboration and Satisfaction About Care Decisions (CSACD). The CSACD was developed to contain 7 questions addressing collaboration, 6 critical questions and 1 global. Content validity for collaboration questions of this instrument was supported by a prior literature review,² nurse and physician experts, and potential subjects. After expert review, the instrument was pilot tested via mailed surveys with focus on transfer decisions. Criterion-related validity and construct validity were supported. Internal consistency of the 6 critical-attribute collaboration items was supported with a Cronbach's alpha coefficient of 0.93.¹

Link to Outcomes or Health System Characteristics: Questionnaire responses correlate to patient outcomes concerning length of stay, mortality and morbidity as well as provider outcomes regarding job satisfaction and retention of ICU nurses.¹

Logic Model/Conceptual Framework: A previously-developed conceptual of collaboration.²

Country: United States

Past or Validated Applications*:

• Patient Age: Not Applicable
• Patient Condition: Not Applicable
• Setting: Inpatient Facility

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

Notes:

• For simplification purposes, in order to properly reference specific items within this profile, all instrument items found in Table 1 of the source article were consecutively numbered.¹
• This instrument contains 9 items; 7 were mapped.

Sources:

1. Baggs JG. Development of an instrument to measure collaboration and satisfaction about care decisions. J Adv Nurs 1994;20: 176-82.
2. Thomas K. Conflict and conflict management. In: MD Dunnette, ed. Handbook of industrial and organizational psychology. Chicago: Rand McNally College Publishing Company; 1976. p. 889-935.
3. Dougherty MB, Larson E. A review of instruments measuring nurse-physician collaboration. J Nurs Adm 2005;35(5):244-53.

Measure #29. Follow-Up Care Delivery

Care Coordination Measure Mapping Table

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

Follow-Up Care Delivery

Purpose: To assess followup care delivery for cancer patients in association with physician specialty.

Format/Data Source: A 16-item, cross-sectional survey covering 4 domains: (1) physician communication, (2) care coordination, (3) nursing care, and (4) interactions with office staff.

Date: Measure published in 2009.¹

Perspective: Patient/Family

Measure Item Mapping:

• Communicate:
  • Between health care professional(s) and patient/family: 1, 2, 4-6, 10
• Information transfer:
  • Between health care professional(s) and patient/family: 9
  • Across health care teams or settings: 11
• Monitor, follow up, and respond to change: 1-16
• Support self-management goals: 4, 9
• Teamwork focused on coordination: 12

Development and Testing: The survey was predominantly a compilation of items from previously validated instruments regarding patient experiences with care. All items underwent cognitive and pilot testing prior to implementation. Bivariate associations, chi-squared tests, and multivariable logistic regression models were performed to test associations of specialty with care coordination, nursing care, quality of care, and more.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

Past or Validated Applications*:

• Patient Age: Adults, Older Adults
• Patient Condition: Combined Chronic Conditions, Cancer/Oncology
• Setting: Primary Care Facility, Other Outpatient Specialty Care Facility

*Based on the source listed below.

Notes:

• For simplification purposes, in order to properly reference specific items within this profile, all instrument items found in Appendix 1 of the source article were consecutively numbered.¹
• This instrument contains 16 items; all 16 were mapped.

Sources:

1. Haggstrom DA, Arora NK, Helft P, et al. Follow-up care delivery among colorectal cancer survivors most often seen by primary and subspecialty care physicians. J Gen Int Med 2009;24(2):472-79.

Measure #30. Family Satisfaction in the Intensive Care Unit (FS-ICU 24)

Care Coordination Measure Mapping Table

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

Family Satisfaction in the Intensive Care Unit (FS-ICU 24)

Purpose: To discern areas for improvement from evaluation of family satisfaction in intensive care units.

Format/Data Source: The FS-ICU 24 questionnaire was administered upon explanatory conversation and consent to participate. Including demographics, 33 items spanned 3 domains: (1) overall satisfaction, (2) satisfaction with care, and (3) information/decisionmaking. Questions were answered via 5-point Likert scale and converted to numerical values on a scale of 0-100. Summary measures (range 0-100) were calculated for FS-ICU_total summary score (higher scores imply greater satisfaction) and on 2 subscales: FS-ICU_care and FS-ICU_dm for information/decisionmaking.

Date: Measure published in 2009.¹

Perspective: Patient/Family

Measure Item Mapping:

• Communicate:
  • Between health care professional(s) and patient/family: 16, 21-25
• Information transfer:
  • Between health care professional(s) and patient/family: 26
• Assess needs and goals: 11, 12, 20
• Teamwork focused on coordination: 13

Development and Testing: An initial version of the questionnaire was tested in ICUs in Canada and was shown to be reliable (correlation coefficient = 0.85) and valid (both content and construct validity). It was able to discriminate between good and poor ratings of ICU quality.^{2, 3}

Link to Outcomes or Health System Characteristics: Little evidence is available addressing links between family satisfaction with quality of critical care for their loved ones and family outcomes, such as burden and stress.⁴

Logic Model/Conceptual Framework: Improved family outcome is based on a conceptual framework presented for palliative care.⁴

Country: German-speaking Switzerland and Canada

Past or Validated Applications*:

• Patient Age: Children
• Patient Condition: General Population/Not Condition Specific
• Setting: Inpatient Facility

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

Notes:

• For simplification purposes, in order to properly reference specific items within this profile, all instrument items found online were consecutively numbered.⁵ The last 3 items were free response and were not mapped.
• This instrument contains 24 items; 11 were mapped.
• For the most updated information, please refer to the Web site.⁵
• An alternate version, the original FS-ICU 34, is available online in Portuguese, French, Chinese, English, German, Hebrew, Spanish, and Swiss French. Further developmental information is available.³
• The FS-ICU 24 is also available online in French, English, German, Greek, Portuguese, Spanish, Swedish, and Swiss French.³ Modifications of both forms are provided online for step-down units as well as a chronic respiratory ward.³

Sources:

1. Stricker KH, Kimberger O, Schmidlin K, et al. Family satisfaction in the intensive care unit: What makes the difference? Int Care Med 2009;35:2051-59.
2. Kryworuchko J, Heyland DK. Using family satisfaction data to improve the processes of care in ICU. Int Care Med 2009;35:2015-7.
3. Heyland DK, Tranmer JE. Measuring family satisfaction with care in the intensive care unit: The development of a questionnaire and preliminary results. J Crit Care 2001;16(4):142-9.
4. Rothen HU, Stricker KH, Heyland DK. Family satisfaction with critical care: Measurements and messages. Curr Opin Crit Care 2010;16:1-9.
5. CARENET. Canadian Researchers at the End of Life Network. Family Satisfaction Survey Web site. Available at: http://www.thecarenet.ca/index.php?option=com_content&view=article&id=135&Itemid=91 Accessed: 16 September 2010.
6. Stricker KH, Niemann S, Bugnon S, et al. Family Satisfaction in the Intensive Care Unit: Cross-cultural adaptation of a questionnaire. J Crit Care 2007; 22:204-11.
7. Wall RJ, Engelberg RA, Downey L, et al. Refinement, scoring, and validation of the Family Satisfaction in the Intensive Care Unit (FS-ICU) survey. Crit Care Med 2007;35(1):271-79.

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